Provider Demographics
NPI:1922047083
Name:LEGGETT, RICHARD JAMES (PA)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:JAMES
Last Name:LEGGETT
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:410 UNIVERSITY PKWY
Mailing Address - Street 2:STE 2360
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-6837
Mailing Address - Country:US
Mailing Address - Phone:803-642-6500
Mailing Address - Fax:803-642-6472
Practice Address - Street 1:410 UNIVERSITY PKWY
Practice Address - Street 2:STE 2360
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-6837
Practice Address - Country:US
Practice Address - Phone:803-642-6500
Practice Address - Fax:803-642-6472
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2017-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA004754363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant