Healthcare Provider Details

I. General information

NPI: 1548964505
Provider Name (Legal Business Name): ADAM LANCE MCLEOD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 CATALINA DR STE 200
ASHLAND OR
97520-1605
US

IV. Provider business mailing address

2825 E BARNETT RD # MSS
MEDFORD OR
97504-8332
US

V. Phone/Fax

Practice location:
  • Phone: 541-201-4800
  • Fax:
Mailing address:
  • Phone: 541-789-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD229518
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: