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General NPI Number Information
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NPI Number | 1902021041
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Entity Type | Individual
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Provider Name | W ERIC MACLEOD MD
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Gender | Male
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 02/06/2013
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Provider Practice Location Address
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Address Line | 100 DOCTORS DRIVE SUITE 101
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City | DOUGLAS
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State | GA
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Zip | 31533
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Country | US
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Telephone | 912-383-6575
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Fax | 912-383-6476
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Provider Business Mailing Address
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Address Line | 210 E. DERENNE AVE ATTN: HOPE SAMS
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City | SAVANNAH
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State | GA
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Zip | 31405
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Country | US
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Telephone | 912-644-5300
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Fax | 912-644-3369
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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 | 053861
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 053861
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License Number State | GA
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