Provider Demographics
NPI:1831082130
Name:MCCLELLAND, ROY LEE JR (PA-C)
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:LEE
Last Name:MCCLELLAND
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:163 COZY CIRCLE LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA CROSS ROADS
Mailing Address - State:PA
Mailing Address - Zip Code:16914-7872
Mailing Address - Country:US
Mailing Address - Phone:570-529-5149
Mailing Address - Fax:
Practice Address - Street 1:740 HIGH ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3102
Practice Address - Country:US
Practice Address - Phone:570-321-2820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant