Healthcare Provider Details

I. General information

NPI: 1780772475
Provider Name (Legal Business Name): MCLEAN JONES PODIATRY CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 04/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6335 N FRESNO ST STE 102
FRESNO CA
93710-5272
US

IV. Provider business mailing address

PO BOX 27195
FRESNO CA
93729-7195
US

V. Phone/Fax

Practice location:
  • Phone: 559-438-0283
  • Fax: 559-438-9201
Mailing address:
  • Phone: 559-438-0283
  • Fax: 559-438-9201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberE3875
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberE3875
License Number StateCA

VIII. Authorized Official

Name: DR. FRANKLYN C JONES
Title or Position: PRESIDENT OWNER
Credential: D.P.M.
Phone: 559-438-0283