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General NPI Number Information
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NPI Number | 1134167687
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Entity Type | Individual
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Provider Name | JEAN HELEN MCCLINTOCK MD
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Gender | Female
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 14810 OLD SAINT AUGUSTINE RD STE 103
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City | JACKSONVILLE
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State | FL
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Zip | 32258-2558
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Country | US
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Telephone | 904-512-1899
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Fax | 904-503-1052
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Provider Business Mailing Address
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Address Line | PO BOX 13834
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City | TALLAHASSEE
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State | FL
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Zip | 32317-3834
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Country | US
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Telephone | 904-512-1899
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Fax | 904-503-1052
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | ME71302
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License Number State | FL
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