Individual
BENJAMIN L MCLEOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
115 31ST AVE SE, MOULTRIE, GA 31768-6771
(229) 890-5305
(229) 890-5307
Mailing address
PO BOX 2317, MOULTRIE, GA 31776-2317
(229) 890-5305
(229) 890-5307
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN218215
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003180779B
—
GA
Enumeration date
09/12/2016
Last updated
07/21/2022
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