Mcclone, Casey M

Mcclone, Casey M is an individual health care provider with primary practice located at 216 Southpark Cir E Ste 216 , St Augustine FL 32086-5135. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Mcclone, Casey M can be contacted via phone (904) 634-0640.

Contact Information

Primary practice address
216 Southpark Cir E Ste 216 St Augustine FL 32086-5135
Phone: (904) 634-0640
Fax: (904) 634-0203
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 51995 Minnesota
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X ME108685 Florida

Profile Details

NPI number 1760688998
LBN Legal business name Mcclone, Casey M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2007
Last updated Oct 9th, 2023 - about 2 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 1760688998 NPPES
Minnesota Other P00771178 MEDICARE RAILROAD
Minnesota MEDICAID 002434000 MEDICARE RAILROAD
Minnesota MEDICAID ENROLLED MEDICARE RAILROAD

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