Organization
SELECT INTERVENTIONAL PAIN, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERRELL L LEGGETT MD (PRESIDENT)
(470) 251-5300
Entity
Organization
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
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
12/20/2014
Last updated
02/19/2017
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