Wallace Beverly Mcleod Iii (NPI# 1922035237, PAC ID# 9133313463) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1922035237 |
| PAC ID by PECOS | 9133313463 |
| Professional Enrollment ID | I20101101001011 |
| Full Name | Wallace Beverly Mcleod Iii |
| Address |
2216 N Martin Luther King Ave Oklahoma City OK 73111-2445 |
| Gender | M |
| Medical School | HOWARD UNIVERSITY COLLEGE OF MEDICINE |
| Graduation Year | 1975 |
| Primary Specialty | FAMILY MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 370037 | ST ANTHONY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 2216 N Martin Luther King Ave, Oklahoma City, OK 73111-2445 |
| Street Address |
2216 N MARTIN LUTHER KING AVE |
| City | OKLAHOMA CITY |
| State | OK |
| Zip | 73111-2445 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Charles W Lunn Jr. | Family Medicine | Centennial Health, PC | 1720 Ne 23rd St, Oklahoma City, OK 73111-3324 |
| David Vu | Family Medicine | Centennial Health, PC | 1720 Ne 23rd St, Oklahoma City, OK 73111-3324 |
| Don Anderson | Clinical Social Worker | Community Health Centers Inc | 1901 Springlake Dr, Oklahoma City, OK 73111-5201 |
| Kevin B Gerold | Anesthesiology | Board of Regents of The University of Oklahoma - Ou Physicians | 2600 Ne 63rd St, Suite 11, Oklahoma City, OK 73111-8301 |
| City | OKLAHOMA CITY |
| Zip Code | 73111 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | OKLAHOMA CITY + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Wallace Beverly Mcleod Iii.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.