Provider Demographics
NPI:1932334463
Name:MCLAIN, CHRISTOPHER KEVIN (IDMT)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:KEVIN
Last Name:MCLAIN
Suffix:
Gender:M
Credentials:IDMT
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Other - Credentials:
Mailing Address - Street 1:420 POST AVE
Mailing Address - Street 2:134TH MEDICAL AID STATION
Mailing Address - City:MCGHEE TYSON AIRBASE
Mailing Address - State:TN
Mailing Address - Zip Code:37777-7602
Mailing Address - Country:US
Mailing Address - Phone:865-985-4286
Mailing Address - Fax:865-985-4273
Practice Address - Street 1:420 POST AVE
Practice Address - Street 2:134TH MEDICAL AID STATION
Practice Address - City:MCGHEE TYSON AIRBASE
Practice Address - State:TN
Practice Address - Zip Code:37777-7602
Practice Address - Country:US
Practice Address - Phone:865-985-4286
Practice Address - Fax:865-985-4273
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians