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NPI Code Detail

MEDICARE: ERIC E MCCLENDON

MEDICARE:   ERIC E MCCLENDON
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
1207RC0000XCardiovascular Disease Physician23906MS

General Provider Information

NPI Number : 1841566288
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC E MCCLENDON
Provider Business Mailing Address
First Line : 965 RIDGE LAKE BLVD STE 103
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-9446
Country : US
Telephone Number :
Fax Number : 901-227-8591
Provider Business Practice Location Address
First Line : 520 WILLOWBROOK RD
Second Line :
City : COLUMBUS
State : MS
Zip : 39705-2015
Country : US
Telephone Number : 662-240-1412
Fax Number : 662-240-1949
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2012
Last Update Date : 07/27/2020

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Directions to “ ERIC E MCCLENDON ” Practice Location

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