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General NPI Number Information
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NPI Number | 1255729919
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Entity Type | Individual
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Provider Name | SAMUEL TYLER LEGER PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/05/2015
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 242 GREEN ST
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City | GARDNER
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State | MA
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Zip | 01440-1336
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Country | US
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Telephone | 978-632-3420
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Fax |
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Provider Business Mailing Address
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Address Line | 15 HOSPITAL DR
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City | YORK
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State | ME
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Zip | 03909-1011
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Country | US
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Telephone | 207-351-2478
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Fax | 207-351-2216
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA1905
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA5320
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License Number State | MA
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