| NPI | 1861711731 |
|---|---|
| Former Legal Business Name | WALLACE B. MCLEOD III, M.D |
| Entity Type | Organization |
| Authorized Contact | JESSIE MAE SHAMBRA Office Manager 405-424-0111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 170100000X Medical Genetics, Ph.D. Medical Genetics (Licence: OK 15393) |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2010-05-18 |