Provider Demographics
NPI:1427022953
Name:MACLEOD, DANIEL T (DO)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:T
Last Name:MACLEOD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:9250 N 3RD ST
Mailing Address - Street 2:SUITE 4010
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2437
Mailing Address - Country:US
Mailing Address - Phone:602-633-3848
Mailing Address - Fax:602-633-3841
Practice Address - Street 1:13555 W MCDOWELL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2624
Practice Address - Country:US
Practice Address - Phone:623-935-4700
Practice Address - Fax:623-935-4707
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2010-12-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ2594207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ117673Medicaid
AZ117673Medicaid
Z108701Medicare PIN
AZF42353Medicare UPIN