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Organization

MARTY R LEGGETT OD PA

Active
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Organization

MARTY R LEGGETT OD PA

Active
Parent organization
MARTY R. LEGGETT, O.D.
Organization subpart
Yes

Provider details

NPI number
Legal business name
MARTY R. LEGGETT, O.D.
Authorized official
DR. MARTY R LEGGETT OD (OWNER)
(352) 391-2967
Entity
Organization

Contact information

Practice address
309 W MAIN ST., LEESBURG, FL 34748
(352) 391-2967
(352) 391-2967
Mailing address
P.O. BOX 490012, LEESBURG, FL 34749-0012
(352) 391-2967
(352) 391-2967

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
OC0002242
FL
152W00000X
Optometrist
Primary
OPC2242
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078819800
—
FL
Enumeration date
12/11/2007
Last updated
01/02/2013
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