Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | DPM00220 | RI |
N | 222Z00000X | Podiatrist | DPM00220 | RI |
Y | 213ES0131X | Foot Surgery | DPM00220 | RI |
NPI | 1104079250 |
---|---|
Provider Name | Dr. John Alexander Macleod |
First Address | Cranston, RI 02910-4436 |
Second Address | Cranston, RI 02910-4436 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2008 |
Last Update Date | 01/11/2008 |