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General NPI Number Information
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NPI Number | 1821319856
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Entity Type | Individual
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Provider Name | ROBERT ANGUS MACLEOD M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2010
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Last Update Date | 07/12/2021
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Provider Practice Location Address
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Address Line | 1800 SE MOBERLY LN STE 4
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City | BENTONVILLE
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State | AR
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Zip | 72712-7017
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Country | US
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Telephone | 479-715-6600
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Fax | 479-521-4603
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Provider Business Mailing Address
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Address Line | PO BOX 1608
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City | FAYETTEVILLE
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State | AR
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Zip | 72702-1608
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Country | US
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Telephone | 479-521-2752
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Fax | 479-521-4603
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | E-9966
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | E-9966
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License Number State | AR
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