Healthcare Provider Details

I. General information

NPI: 1104968403
Provider Name (Legal Business Name): RICHARD PRESTON LEGGETT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1906 BRAEBURN DR
SALEM VA
24153-7304
US

IV. Provider business mailing address

2000 HEALTH PARK DR FL HP2
BRENTWOOD TN
37027-4692
US

V. Phone/Fax

Practice location:
  • Phone: 540-444-0460
  • Fax: 540-444-0479
Mailing address:
  • Phone: 615-373-7600
  • Fax: 866-346-1426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101049756
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: