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General NPI Number Information
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NPI Number | 1275521015
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Entity Type | Individual
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Provider Name | NORMAN G. MACLEOD M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 128 MARKET ST
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City | ALAMOSA
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State | CO
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Zip | 81101-2290
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Country | US
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Telephone | 719-587-1001
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 S. CONWELL STREET
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City | CASPER
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State | WY
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Zip | 82601
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Country | US
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Telephone | 307-265-8300
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Fax | 307-233-8230
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 36534
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License Number State | CO
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