Provider Demographics
NPI:1073894721
Name:MCLEOD, J'SHAUN ANDRE' (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:J'SHAUN
Middle Name:ANDRE'
Last Name:MCLEOD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4686 CREEKSIDE VILLAS WAY SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-4895
Mailing Address - Country:US
Mailing Address - Phone:770-863-3511
Mailing Address - Fax:
Practice Address - Street 1:4120 AUSTELL RD
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1841
Practice Address - Country:US
Practice Address - Phone:770-941-2918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH022697183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist