Individual
JOHN MARCUS LEGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 E TICKLE ST, DYERSBURG, TN 38024-3120
(731) 285-2346
Mailing address
PO BOX 1296, DYERSBURG, TN 38025-1296
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD25386
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3083641
—
TN
Enumeration date
08/31/2005
Last updated
01/11/2010
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