Healthcare Provider Details

I. General information

NPI: 1851365050
Provider Name (Legal Business Name): PATRICIA LEGANT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 08/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5126 W DAYBREAK PARKWAY SOUTH JORDAN MEDICAL CENTER
SOUTH JORDAN UT
84095
US

IV. Provider business mailing address

5126 W DAYBREAK PARKWAY UUMC SOUTH JORDAN MEDICAL CENTER
SOUTH JORDAN UT
84095
US

V. Phone/Fax

Practice location:
  • Phone: 801-213-4319
  • Fax:
Mailing address:
  • Phone: 801-213-4319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number164347-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: