Healthcare Provider Details

I. General information

NPI: 1013339233
Provider Name (Legal Business Name): DEREK LEGG DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2014
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13757 W BELL RD STE 101
SURPRISE AZ
85374-2452
US

IV. Provider business mailing address

13757 W BELL RD STE 101
SURPRISE AZ
85374-2452
US

V. Phone/Fax

Practice location:
  • Phone: 623-214-7600
  • Fax:
Mailing address:
  • Phone: 623-214-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8366
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: