Provider Demographics
NPI:1861820201
Name:MCLEOD, BARRY
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:MCLEOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:OK
Mailing Address - Zip Code:73662-0037
Mailing Address - Country:US
Mailing Address - Phone:580-821-0092
Mailing Address - Fax:
Practice Address - Street 1:330 W GRAY ST
Practice Address - Street 2:SUITE 140
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-7129
Practice Address - Country:US
Practice Address - Phone:405-919-6821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-22
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst