Basic Information
| Provider Information | |||||||||
| NPI: | 1477551109 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCLEOD | ||||||||
| FirstName: | WAYNE | ||||||||
| MiddleName: | C. | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | APRN-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6422 E SPEEDWAY BLVD | ||||||||
| Address2: | STE 150 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857101149 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203183004 | ||||||||
| FaxNumber: | 5203183061 | ||||||||
| Practice Location | |||||||||
| Address1: | 6422 E SPEEDWAY BLVD | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857101149 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203183004 | ||||||||
| FaxNumber: | 5203183061 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2005 | ||||||||
| LastUpdateDate: | 05/23/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP2122 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.