Individual
DR. DERRELL LEVOHN LEGGETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
794 MCDONOUGH RD, SUITE 108, JACKSON, GA 30233-1572
(470) 251-5300
(470) 251-5301
Mailing address
794 MCDONOUGH RD, SUITE 108, JACKSON, GA 30233-1572
(470) 251-5300
(470) 251-5301
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
133964
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
66346
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
66346
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003118346C
—
GA
Enumeration date
11/02/2007
Last updated
05/24/2022
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