Provider Demographics
NPI:1548467715
Name:LEGG, PHILLIP P (DO)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:P
Last Name:LEGG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:641 MADIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-6715
Mailing Address - Country:US
Mailing Address - Phone:304-598-4929
Mailing Address - Fax:304-598-4930
Practice Address - Street 1:1 MEDICAL CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506
Practice Address - Country:US
Practice Address - Phone:304-598-4929
Practice Address - Fax:304-598-4930
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV2092207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology