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NPI Code Detail

MEDICARE: DR. WILLIAM LYLE MCCLUNG MD

MEDICARE:  DR. WILLIAM LYLE MCCLUNG  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician0101056236VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3289290OTHERVAANTHEM
4225525OTHERVASO. HEALTH

General Provider Information

NPI Number : 1043214067
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM LYLE MCCLUNG MD
Provider Business Mailing Address
First Line : 213 S JEFFERSON ST STE 1006
Second Line :
City : ROANOKE
State : VA
Zip : 24011-1713
Country : US
Telephone Number : 540-224-5352
Fax Number :
Provider Business Practice Location Address
First Line : 1 HEALTH CIR
Second Line :
City : LEXINGTON
State : VA
Zip : 24450-2448
Country : US
Telephone Number : 540-458-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2005
Last Update Date : 12/06/2023

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Directions to “ DR. WILLIAM LYLE MCCLUNG MD” Practice Location

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