1750584595 NPI number — XIAO Q. MCLINTON RN PC

Table of content: (NPI 1750584595)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750584595 NPI number — XIAO Q. MCLINTON RN PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
XIAO Q. MCLINTON RN PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CORNER CARE CLINIC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750584595
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10401 N MERIDIAN ST
Provider Second Line Business Mailing Address:
STE 310
Provider Business Mailing Address City Name:
INDIANAPOLIS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46290-1151
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-428-6909
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 HIGHWAY 70 EAST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HILLSBOROUGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27278
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-732-3064
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MCLINTON
Authorized Official First Name:
XIAO
Authorized Official Middle Name:
Q.
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
317-428-6909

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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