# MCCLANE & STUBITS OD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982617619
- **Authorized official:** DR. JOHN W MCCLANE III OD (PRESIDENT OWNER)
- **Authorized official phone:** (904) 261-5741

## Contact information

- **Practice address:** 6 S 14TH ST, FERNANDINA BEACH, FL 32034-3212
- **Practice address phone:** (904) 261-5741
- **Practice address fax:** (904) 261-7383
- **Mailing address:** 6 S 14TH ST, FERNANDINA, FL 32034-3212
- **Mailing address phone:** (904) 261-5741
- **Mailing address fax:** (904) 261-7383

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 1488 | FL | Yes |

## Other

- **Enumeration date:** 08/14/2006
- **Last updated:** 02/08/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 078182700 | — | FL |
| 05 | — | 078226200 | — | FL |