Individual
MARK D. MCCLINTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3240 EDWARDS LAKE PKWY STE 100, BIRMINGHAM, AL 35235-3128
(833) 733-8742
(205) 634-5640
Mailing address
3240 EDWARDS LAKE PKWY STE 100, BIRMINGHAM, AL 35235-3128
(833) 733-8742
(205) 634-5640
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S-612-TA-580
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051504832
BLUECROSS/BLUE SHIELD ALA
AL
05
—
051504832
—
AL
01
—
410046871
RAILROAD MEDICARE
AL
Enumeration date
05/28/2005
Last updated
04/15/2026
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