Individual
RANDI J. MCLEOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 HOSPITAL DR, LEWISBURG, PA 17837-9350
(570) 522-2640
(570) 768-3921
Mailing address
1 HOSPITAL DR STE 306, LEWISBURG, PA 17837-9350
(570) 522-4110
(570) 768-3911
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD056652L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02752156
NEW YORK MEDICAID
NY
05
—
15798530005
—
PA
01
—
232809429
TRICARE
—
01
—
321845
HEALTH AMERICA
PA
01
—
855947
HIGHMARK BLUE SHIELD
PA
01
—
930034292
RAILROAD MEDICARE
PA
Enumeration date
05/24/2006
Last updated
05/24/2022
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