Jacob Myles Mcleod
Foot & Ankle Surgery
625 9th Ave Ste 210
Longview
, Washington 98632-2465
Jacob Myles Mcleod
Foot & Ankle Surgery
625 9th Ave Ste 210
Longview
, Washington 98632-2465
(360) 423-5682
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About
Features
Specialties
- Foot & Ankle Surgery
Languages spoken
- English
Location
First Address
- Jacob Myles Mcleod
- 625 9th Ave Ste 210
- Longview, WA
- Zip : 98632-2465
- Fax : (360) 423-5682
- Phone : (360) 501-3400
Second Address
- Jacob Myles Mcleod
- 625 9th Ave Ste 210
- Longview, WA
- Zip : 98632-2465
- Fax : (360) 423-5682
- Phone : (360) 501-3400
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Is Jacob Myles Mcleod a sole practitioner?
Is Jacob Myles Mcleod accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213ES0103X | Foot & Ankle Surgery | PO60466892 | WA |
National Provider Identifier
| NPI | 1083909329 |
|---|---|
| Provider Name | Jacob Myles Mcleod |
| First Address | Longview, WA 98632-2465 |
| Second Address | Longview, WA 98632-2465 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/06/2011 |
| Last Update Date | 31/12/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0304956 | WASHINGTON L&I (01) | WA |
| 1083909329 | (05) | OR |
| 1083909329 | (05) | WA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.