Healthcare Provider Details

I. General information

NPI: 1144586280
Provider Name (Legal Business Name): CHRISTOPHER M MCCLINTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2012
Last Update Date: 07/21/2022
Certification Date: 03/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 E MONTE PAINTER DR
FAYETTEVILLE AR
72703-4014
US

IV. Provider business mailing address

3232 N NORTH HILLS BLVD
FAYETTEVILLE AR
72703-4014
US

V. Phone/Fax

Practice location:
  • Phone: 479-695-4234
  • Fax:
Mailing address:
  • Phone: 479-695-4234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberE-10624
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: