Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0117X | Orthopaedic Spine Surgeon | 2014007081 | MO |
Y | 2084N0400X | Neurologist | 50241 | AZ |
NPI | 1275799025 |
---|---|
Provider Name | Dr. Jamal Mcclendon JR. |
First Address | Phoenix, AZ 85054-4502 |
Second Address | Scottsdale, AZ 85259-5452 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2008 |
Last Update Date | 08/09/2020 |