MEDICARE: JAMES C MCLENNAN MD PC

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
1	207Q00000X	Family Medicine Physician	4536	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588760169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES C MCLENNAN MD PC

Provider Business Mailing Address
First Line	:	513 HAMMILL LN
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-1004
Country	:	US
Telephone Number	:	775-358-3522
Fax Number	:	775-828-9466

Provider Business Practice Location Address
First Line	:	513 HAMMILL LN
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-1004
Country	:	US
Telephone Number	:	775-358-3522
Fax Number	:	775-828-9466

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	03/18/2009

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