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DR. DERRELL LEVOHN LEGGETT M.D.

>> Anesthesiology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1306025630

Individual Registrant:
DR. DERRELL LEVOHN LEGGETT M.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
794 MCDONOUGH RD SUITE 108 JACKSON, GA 30233-1572 US
Tel: 470-251-5300  Fax: 470-251-5301

Contact information for business:
794 MCDONOUGH RD SUITE 108 JACKSON, GA 30233-1572 US
Tel: 470-251-5300  Fax: 470-251-5301

Registration Information:
NPI: 1306025630
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N207L00000XAllopathic & Osteopathic Physicians
Anesthesiology
NC133964
N207LP2900XAllopathic & Osteopathic Physicians
Anesthesiology
GA66346
Y208VP0014XAllopathic & Osteopathic Physicians
Pain Medicine
GA66346

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
003118346BGA05




HEALTH CARE JOBS GA - Page 1



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