Individual
JEFFREY S MCCLELLAN
Active
Individual
JEFFREY S MCCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
261367-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002331009
—
UT
01
—
107006909113
IHC
UT
01
—
226527
DMBA
UT
01
—
870284448MC1
EMIA
UT
Enumeration date
05/18/2006
Last updated
10/15/2015
Update your record
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