Provider Demographics
NPI:1598758898
Name:MCLEISH, WILLIAM M (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:M
Last Name:MCLEISH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10645 N TATUM BLVD
Mailing Address - Street 2:SUITE 200-406
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3068
Mailing Address - Country:US
Mailing Address - Phone:480-720-6706
Mailing Address - Fax:480-315-8802
Practice Address - Street 1:1331 N 7TH ST
Practice Address - Street 2:SUITE 290
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2754
Practice Address - Country:US
Practice Address - Phone:602-230-6744
Practice Address - Fax:480-315-8802
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2020-10-16
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Provider Licenses
StateLicense IDTaxonomies
AZ25606207WX0200X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
E27801Medicare UPIN
AZ83878Medicare ID - Type Unspecified