Provider Demographics
NPI:1639240963
Name:LEGRAND, MILTON PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:MILTON
Middle Name:PAUL
Last Name:LEGRAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 SAINT CLAIR AVE SW
Mailing Address - Street 2:BUILDING 8 SUITE 22
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5008
Mailing Address - Country:US
Mailing Address - Phone:256-533-6003
Mailing Address - Fax:
Practice Address - Street 1:600 SAINT CLAIR AVE SW
Practice Address - Street 2:BUILDING 8 SUITE 22
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5008
Practice Address - Country:US
Practice Address - Phone:256-533-6003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00007864207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL05387OtherBCBS OF AL PROVIDER #
AL4003589OtherAETNA PROVIDER #
AL4810029OtherUHC PROVIDER #
TN4401083Medicaid
AL05387OtherBCBS OF AL PROVIDER #