Provider Demographics
NPI:1700383494
Name:LEGRAND, JASON NATHANIEL (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:NATHANIEL
Last Name:LEGRAND
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1024 ARBORGATE CIR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-6503
Mailing Address - Country:US
Mailing Address - Phone:703-965-2941
Mailing Address - Fax:
Practice Address - Street 1:101 MANNING DR RM C3162
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:919-966-4676
Practice Address - Fax:919-966-6718
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2022-01691207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology