Provider Demographics
NPI:1093883357
Name:LEGGETT, KAREN FECHTER (DO)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:FECHTER
Last Name:LEGGETT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 SE 41ST AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:FL
Mailing Address - Zip Code:32693-5003
Mailing Address - Country:US
Mailing Address - Phone:941-685-8914
Mailing Address - Fax:
Practice Address - Street 1:3896 EASTON ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-2601
Practice Address - Country:US
Practice Address - Phone:941-685-8914
Practice Address - Fax:941-349-9301
Is Sole Proprietor?:No
Enumeration Date:2006-12-02
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 8251207QA0505X, 207QG0300X
FLOS8251207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE4994XMedicare ID - Type Unspecified
FLH30043Medicare UPIN