MEDICARE: JEAN HELEN MCCLINTOCK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	ME71302	FL

General Provider Information

NPI Number	:	1134167687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN HELEN MCCLINTOCK MD

Provider Business Mailing Address
First Line	:	PO BOX 13834
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32317-3834
Country	:	US
Telephone Number	:	904-512-1899
Fax Number	:	904-503-1052

Provider Business Practice Location Address
First Line	:	14810 OLD SAINT AUGUSTINE RD STE 103
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-2558
Country	:	US
Telephone Number	:	904-512-1899
Fax Number	:	904-503-1052

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	11/26/2025

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