Healthcare Provider Details

I. General information

NPI: 1336099464
Provider Name (Legal Business Name): JAMES CLINTON MCCORMICK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CLINT MCCORMICK

II. Dates (important events)

Enumeration Date: 01/29/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 AL-157 SUITE 420B
CULLMAN AL
35058
US

IV. Provider business mailing address

1890 AL-157 SUITE 420B
CULLMAN AL
35058
US

V. Phone/Fax

Practice location:
  • Phone: 256-736-2263
  • Fax:
Mailing address:
  • Phone: 256-736-2263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-163008
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: