Provider Demographics
NPI:1265535488
Name:MCLEOD, JEFF L (MD)
Entity type:Individual
Prefix:DR
First Name:JEFF
Middle Name:L
Last Name:MCLEOD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5001 WEST VILLAGE GREEN DRIVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112
Mailing Address - Country:US
Mailing Address - Phone:804-763-1058
Mailing Address - Fax:804-763-2693
Practice Address - Street 1:5001 WEST VILLAGE GREEN DRIVE
Practice Address - Street 2:SUITE 108
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112
Practice Address - Country:US
Practice Address - Phone:804-763-1058
Practice Address - Fax:804-763-2693
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA50376207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010128056Medicaid
VA010128056Medicaid
VAC09433Medicare ID - Type Unspecified