Provider Demographics
NPI:1306135488
Name:MACLEOD, LIAM CONNOR (MD)
Entity type:Individual
Prefix:
First Name:LIAM
Middle Name:CONNOR
Last Name:MACLEOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:691 MURPHY RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-4346
Mailing Address - Country:US
Mailing Address - Phone:541-789-5121
Mailing Address - Fax:
Practice Address - Street 1:691 MURPHY RD STE 107
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-4311
Practice Address - Country:US
Practice Address - Phone:541-789-5121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD189330208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology