Individual
MICHAEL ROY MCLEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 N MOUND ST, NACOGDOCHES, TX 75961-4029
(936) 560-2990
(936) 560-5734
Mailing address
PO BOX 632749, NACOGDOCHES, TX 75963-2749
(936) 560-2990
(936) 560-5734
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
E2718
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0825200-01
—
TX
01
—
81K363
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/26/2006
Last updated
07/22/2010
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