Mcclanahan, William Shane

Mcclanahan, William Shane is an individual health care provider with primary practice located at 1409 Kingsley Ave Ste 14A , Orange Park FL 32073-4541. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Mcclanahan, William Shane can be contacted via phone (904) 213-3555.

Contact Information

Primary practice address
1409 Kingsley Ave Ste 14A Orange Park FL 32073-4541
Fax: (904) 272-1222
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA2114 Florida

Profile Details

NPI number 1962493932
LBN Legal business name Mcclanahan, William Shane
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2005
Last updated Oct 17th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962493932 NPPES
Florida MEDICAID 291267800

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