Mcclintock, Mark D

Mcclintock, Mark D is an individual health care provider with primary practice located at 3240 Edwards Lake Pkwy Ste 100, Birmingham AL 35235-3128. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mcclintock, Mark D can be contacted via phone (205) 949-2020.

Contact Information

Primary practice address
3240 Edwards Lake Pkwy Ste 100 Birmingham AL 35235-3128
Fax: (205) 949-1400
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X S-612-TA-580 Alabama

Profile Details

NPI number 1750384202
LBN Legal business name Mcclintock, Mark D
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 28th, 2005
Last updated Apr 29th, 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 1750384202 NPPES
Alabama Other 051504832 BLUECROSS/BLUE SHIELD ALA
Alabama Other 410046871 BLUECROSS/BLUE SHIELD ALA
Alabama MEDICAID 051504832 BLUECROSS/BLUE SHIELD ALA

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