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NPI Code Detail

MEDICARE: GARY LEE LEGLER D.O.

MEDICARE: GARY LEE LEGLER D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician0517972KS

General Provider Information

NPI Number : 1295782233
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY LEE LEGLER D.O.
Provider Business Mailing Address
First Line : 4810 STATE AVE
Second Line :
City : KANSAS CITY
State : KS
Zip : 66102-1748
Country : US
Telephone Number : 913-945-9740
Fax Number : 913-945-9741
Provider Business Practice Location Address
First Line : 4810 STATE AVE
Second Line :
City : KANSAS CITY
State : KS
Zip : 66102-1748
Country : US
Telephone Number : 913-945-9740
Fax Number : 913-945-9741
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2006
Last Update Date : 04/17/2013

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