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Individual

DR. JAMES STUART MCCLELLAN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1601 HARMON AVE STE 1D03, FORT STEWART, GA 31314-5611
(912) 435-6633
Mailing address
1601 HARMON AVE STE 1D03, FORT STEWART, GA 31314-5611
(912) 435-6633

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
067252
GA
208D00000X
General Practice Physician
0101056826
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0101056826
STATE MEDICAL LICENSE
VA
Enumeration date
11/18/2005
Last updated
05/05/2016
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