Provider Demographics
NPI:1558354571
Name:LEGAKO, EDWARD A (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:A
Last Name:LEGAKO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3201 W GORE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-6378
Mailing Address - Country:US
Mailing Address - Phone:580-353-8942
Mailing Address - Fax:580-353-5008
Practice Address - Street 1:3201 W GORE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6378
Practice Address - Country:US
Practice Address - Phone:580-353-8942
Practice Address - Fax:580-353-5008
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
OK12378208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics