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Individual

DOUGLAS R. MCCLOY II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
254 S MAIN ST, MARION, OH 43302
(740) 387-6880
(740) 387-7443
Mailing address
254 S MAIN ST, MARION, OH 43302
(740) 387-6880
(740) 387-7443

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
4665 T1440
OH
152W00000X
Optometrist
Primary
OH4665
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000223971
ANTHEM
OH
01
1791851
UNITED HEALTHCARE
OH
05
2036764
OH
01
410048818
RAILROAD MEDICARE
OH
01
410048891
RAILROAD MEDICARE
OH
01
5340225
AETNA
OH
Enumeration date
07/20/2005
Last updated
02/02/2010
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