Provider Demographics
NPI:1841359700
Name:MACLEOD, SCOTT (DO)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:MACLEOD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3827 N 10TH ST STE 305
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-1745
Mailing Address - Country:US
Mailing Address - Phone:702-796-7546
Mailing Address - Fax:702-869-6146
Practice Address - Street 1:653 N TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-0514
Practice Address - Country:US
Practice Address - Phone:702-796-7546
Practice Address - Fax:702-869-6146
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV610208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVP00287084OtherRR MEDICARE
NVCC8832OtherANTHEM
NVCC8832OtherBCBS
NVV100733Medicare PIN
NVF25109Medicare UPIN