Individual
KYLE MCLEOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-0211
Mailing address
1499 WALTON WAY, STE 1400, AUGUSTA, GA 30901-2602
(706) 721-0211
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
038050
GA
207P00000X
Emergency Medicine Physician
Primary
19636
WV
207P00000X
Emergency Medicine Physician
35083684
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0180085
—
OH
Enumeration date
08/15/2006
Last updated
02/02/2017
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