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Individual

KENNETH DEAN MCLEOD SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1511 N MCKENZIE ST, FOLEY, AL 36535-2235
(251) 943-1584
(251) 943-7442
Mailing address
1511 N MCKENZIE ST, FOLEY, AL 36535-2235
(251) 943-1584
(251) 943-7442

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO24
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000004250
AL
01
0110393
MEDICARE COMPLETE
01
406231011
RAILROAD MEDICARE
01
4314829
AETNA
01
51004250
BCBS
AL
01
69634
FIRST HEALTH
Enumeration date
10/16/2006
Last updated
12/15/2009
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