Provider Demographics
NPI:1831633502
Name:JAMES LEGRAND MD, LLC
Entity type:Organization
Organization Name:JAMES LEGRAND MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEGRAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-300-0370
Mailing Address - Street 1:7855 S EMERSON AVE
Mailing Address - Street 2:SUITE H
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-8668
Mailing Address - Country:US
Mailing Address - Phone:317-300-0370
Mailing Address - Fax:317-300-0422
Practice Address - Street 1:7855 S EMERSON AVE
Practice Address - Street 2:SUITE H
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8668
Practice Address - Country:US
Practice Address - Phone:317-300-0370
Practice Address - Fax:317-300-0422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01041511A207RH0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty