Organization
MCCLANE & STUBITS OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN W MCCLANE III OD (PRESIDENT OWNER)
(904) 261-5741
Entity
Organization
Contact information
Practice address
6 S 14TH ST, FERNANDINA BEACH, FL 32034-3212
(904) 261-5741
(904) 261-7383
Mailing address
6 S 14TH ST, FERNANDINA, FL 32034-3212
(904) 261-5741
(904) 261-7383
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1488
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078182700
—
FL
05
—
078226200
—
FL
Enumeration date
08/14/2006
Last updated
02/08/2011
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