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Individual

DR. REGINALD JAY MCCLUNG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
331 LAIDLEY ST, SUITE 205, CHARLESTON, WV 25301-1619
(304) 344-2345
(304) 344-2347
Mailing address
331 LAIDLEY ST, SUITE 205, CHARLESTON, WV 25301-1619
(304) 344-2345
(304) 344-2347

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14073
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001874582
BLUE CROSS BLUE SHIELD
WV
05
0051700000
WV
01
080018703
RAILROAD MEDICARE
WV
Enumeration date
10/28/2006
Last updated
02/11/2014
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