Provider Demographics
NPI:1649267907
Name:MCCLELLAND, JOHN D (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:D
Last Name:MCCLELLAND
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 3014
Mailing Address - Street 2:1215 DUFF AVE, MCFARLAND CLINIC, PC
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-3014
Mailing Address - Country:US
Mailing Address - Phone:515-239-4496
Mailing Address - Fax:515-239-4767
Practice Address - Street 1:3800 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50014-3402
Practice Address - Country:US
Practice Address - Phone:515-956-4100
Practice Address - Fax:515-956-4108
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2020-12-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA001514363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAQ05622Medicare UPIN