Provider Demographics
NPI:1982080966
Name:MCCLENDON, JOHN BATTON III (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:BATTON
Last Name:MCCLENDON
Suffix:III
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8820 ROGERS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-5245
Mailing Address - Country:US
Mailing Address - Phone:479-452-0278
Mailing Address - Fax:479-452-2587
Practice Address - Street 1:8820 ROGERS AVE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5245
Practice Address - Country:US
Practice Address - Phone:479-452-0278
Practice Address - Fax:479-452-2587
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD6686183500000X
MSE-6086183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist