Provider Demographics
NPI:1558355917
Name:MCLEOD, WILLIAM P (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:MCLEOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 PALMETTO ST
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32168-7325
Mailing Address - Country:US
Mailing Address - Phone:386-424-9601
Mailing Address - Fax:
Practice Address - Street 1:504 PALMETTO ST
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-7325
Practice Address - Country:US
Practice Address - Phone:386-424-9601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME35519207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL64422OtherBLUE CROSS BLUE SHIELD
FL004597OtherFLORIDA HEALTH CARE
FL0500350OtherGHI
FL200014072OtherRAILROAD MEDICARE
FLT8467OtherPRINCIPAL
FL4087496OtherAETNA
FL4087496OtherAETNA
FL64422OtherBLUE CROSS BLUE SHIELD
FL200014072OtherRAILROAD MEDICARE
FLT8467OtherPRINCIPAL