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General NPI Number Information
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NPI Number | 1487894945
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Entity Type | Individual
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Provider Name | MARK W. MCCLUNG FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 02/24/2009
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Last Update Date | 06/15/2009
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Provider Practice Location Address
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Address Line | 311 CHESTNUT AVE
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City | OAK HILL
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State | WV
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Zip | 25901-2104
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Country | US
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Telephone | 304-575-0360
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Fax |
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Provider Business Mailing Address
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Address Line | 311 CHESTNUT AVE
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City | OAK HILL
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State | WV
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Zip | 25901-2104
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Country | US
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Telephone |
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 58787
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License Number State | WV
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