Individual
JOHN WILLIAM MCCLANE IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
39580 S LAGO DEL ORO PKWY, TUCSON, AZ 85739-1091
(520) 624-4000
Mailing address
200 MULLINS DR, LEBANON, OR 97355-3983
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
007970
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/06/2014
Last updated
04/27/2020
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