Mcleod, Benjamin L
Mcleod, Benjamin L is an individual health care provider with primary practice located at 115 31St Ave Se , Moultrie GA 31768-6771. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Mcleod, Benjamin L can be contacted via phone (229) 890-5305.Contact Information
Primary practice address
115 31St Ave Se
Moultrie GA 31768-6771
Phone: (229) 890-5305
Fax: (229) 890-5307
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN218215 | Georgia |
Profile Details
| NPI number | 1417405176 |
|---|---|
| LBN Legal business name | Mcleod, Benjamin L |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 12th, 2016 |
| Last updated | Jul 21st, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417405176 | NPPES |
| Georgia | MEDICAID | 003180779B |
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