Organization Name: | R.J. LEGREID II, MD |
NPI Number: | 1376712927 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RUSSEL J LEGREID (PREDISENT) |
Mailing Address: | 1255 E College St Pulaski |
State: | TN US |
Postal Code: | 384784515 |
Phone Number: | 9313630343 |
Fax Number: | 9313632604 |
NPI Enumeration Date: | 02/28/2008 |
NPI Last Update Date: | 06/27/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 39319 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |