Individual
CARROLL M MCLEOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 354-4488
(601) 351-5980
Mailing address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 354-4488
(601) 351-5980
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
12138
MS
208VP0000X
Pain Medicine Physician
Primary
12138
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00110112
—
MS
Enumeration date
01/18/2007
Last updated
08/18/2021
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