Healthcare Provider Details

I. General information

NPI: 1588573364
Provider Name (Legal Business Name): JOSEPH MCLEAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 E STATE ST
COLUMBUS OH
43215-4281
US

IV. Provider business mailing address

168 CAROL PL
DOUGLASVILLE GA
30134-7312
US

V. Phone/Fax

Practice location:
  • Phone: 614-726-1485
  • Fax: 877-564-4386
Mailing address:
  • Phone: 704-661-3327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: