Individual
PAULA J LEGERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2310 HERON ST, BRUNSWICK, GA 31520-4239
(912) 265-8988
(912) 265-0996
Mailing address
2310 HERON ST, BRUNSWICK, GA 31520-4239
(912) 265-8988
(912) 265-0996
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
GA045871
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00804053B
—
GA
01
—
240006575
RAILROAD MEDICARE
GA
Enumeration date
10/03/2006
Last updated
02/19/2014
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