Provider Demographics
NPI:1356305940
Name:MCLEOD, FRED ANTHONY (M D)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:ANTHONY
Last Name:MCLEOD
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3368 HIGHWAY 280
Mailing Address - Street 2:STE G-15
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35010-3375
Mailing Address - Country:US
Mailing Address - Phone:256-329-1114
Mailing Address - Fax:256-329-2202
Practice Address - Street 1:3368 HIGHWAY 280
Practice Address - Street 2:STE G-15
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-3393
Practice Address - Country:US
Practice Address - Phone:256-329-1114
Practice Address - Fax:256-329-2202
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME143911207YS0012X
AL00016702174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000036822Medicaid
FL108007000Medicaid
AL000036822Medicaid