Provider Demographics
NPI:1609683507
Name:MACLEOD, ALASTAIR (MACOM)
Entity type:Individual
Prefix:MR
First Name:ALASTAIR
Middle Name:
Last Name:MACLEOD
Suffix:
Gender:M
Credentials:MACOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12901 N FOX HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:MARANA
Mailing Address - State:AZ
Mailing Address - Zip Code:85653-7909
Mailing Address - Country:US
Mailing Address - Phone:805-858-8154
Mailing Address - Fax:
Practice Address - Street 1:2252 W MAGEE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-4329
Practice Address - Country:US
Practice Address - Phone:805-858-8154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-13
Last Update Date:2024-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-012246171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist