Provider Demographics
NPI:1275817868
Name:LEGGETT, CYNTHIA CORRELL (BSPHARM)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:CORRELL
Last Name:LEGGETT
Suffix:
Gender:F
Credentials:BSPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FARMER INDUSTRIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-1078
Mailing Address - Country:US
Mailing Address - Phone:770-251-6778
Mailing Address - Fax:770-251-9192
Practice Address - Street 1:1 FARMER INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-1078
Practice Address - Country:US
Practice Address - Phone:770-251-6778
Practice Address - Fax:770-251-9192
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH013920183500000X
NC07193183500000X
VA0202004363183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist