Individual
MITCHELL ALEXANDER MCCLELLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
307 BOATNER RD STE 114, EGLIN AFB, FL 32542-1302
(850) 883-8754
Mailing address
WPAFB, 4481 SUGAR MAPLE DRIVE, DAYTON, OH 45433-5529
(937) 522-4784
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
34.016149
OH
2083A0100X
Aerospace Medicine Physician
Primary
34.016149
OH
390200000X
Student in an Organized Health Care Education/Training Program
34.016149
OH
Other
Enumeration date
04/24/2020
Last updated
10/05/2023
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