DR. DERRELL LEVOHN LEGGETT (NPI# 1306025630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1306025630 |
Entity Type | Individual |
Full Name | DR. DERRELL LEVOHN LEGGETT |
Credential | M.D. |
Practice Address |
794 Mcdonough Rd Suite 108 Jackson GA 30233-1572 |
Practice Telephone | 4702515300 |
Practice Fax Number | 4702515301 |
Mailing Telephone | 4702515300 |
Mailing Fax Number | 4702515301 |
Enumeration Date | 2007-11-02 |
Last Update Date | 2018-01-23 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207L00000X | Anesthesiology | 133964 | NC | Allopathic & Osteopathic Physicians |
N | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
66346 | GA | Allopathic & Osteopathic Physicians |
Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
66346 | GA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 003118346B | 05 |
Street Address |
794 MCDONOUGH RD SUITE 108 |
City | JACKSON |
State | GA |
Zip Code | 30233-1572 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558330522 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 794 Mcdonough Rd, Jackson, GA 30233-1572 | 2006-03-14 |
1740755719 | Byron A Thompson | Counselor | 794 Mcdonough Rd, Jackson, GA 30233 | 2018-10-05 |
1750789947 | Select Interventional Pain, PC | Pain Medicine | 794 Mcdonough Rd, Suite 108, Jackson, GA 30233-1572 | 2014-12-20 |
1306126529 | Jaimi Marie Norrell | Nurse Practitioner | 794 Mcdonough Rd, 111, Jackson, GA 30233-1572 | 2011-08-18 |
1992943195 | Dana B Bass Burch | Physician Assistant | 794 Mcdonough Rd, Suite 111, Jackson, GA 30233-1572 | 2009-01-26 |
1093963944 | South Georgia Treatment, Inc | Clinic/Center | 794 Mcdonough Rd, Jackson, GA 30233-1572 | 2008-09-04 |
1306019104 | Bennie R White Jr Md Inc | Clinic/Center | 794 Mcdonough Rd, Suite 105, Jackson, GA 30233-1572 | 2008-04-12 |
1033329198 | Jackson Dialysis Center | Clinic/Center | 794 Mcdonough Rd, Suite 108, Jackson, GA 30233-1572 | 2007-05-23 |
1376575225 | Bennie R. White Jr. | Family Medicine | 794 Mcdonough Rd, Suite 105, Jackson, GA 30233-1572 | 2006-07-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366800914 | Georgia Ophthalmologists LLC | Durable Medical Equipment & Medical Supplies | 860 W 3rd St, Jackson, GA 30233 | 2016-02-10 |
1306225057 | Young Dreaden | Nurse Practitioner | 2978 Hwy 36w, Jackson, GA 30233 | 2015-05-28 |
1609255520 | Neta J Roby | Nurse Practitioner | Hwy 36, Georgia Diagnostic Classification Prison, Jackson, GA 30233 | 2015-05-26 |
1033546098 | Henrietta Lindsay | Social Worker | 463-b Ernest Biles Dr, Jackson, GA 30233 | 2013-10-04 |
1255776993 | Gareth Gene Walker | Technician | 514 Covinton Street, Jackson, GA 30233 | 2013-05-08 |
1730489592 | Mary L. Melton | Licensed Practical Nurse | 463 Ernest Biles Dr., Jackson, GA 30233 | 2010-10-27 |
1083864250 | Chastity Moore Brown | Dentist | 1520 Lucky Street, Griffin, GA 30233 | 2008-09-24 |
1568661320 | Joseph Fowlkes | Internal Medicine | 2978 Highway 36 W, Jackson, GA 30233 | 2007-07-12 |
1942386289 | Butts County Board of Commissioners | Ambulance | 154 Sylvan Drive, Jackson, GA 30233 | 2006-10-30 |
1841238300 | Jackson Pharmacy Services | Pharmacy | 22 Mulberry St., Jackson, GA 30233 | 2006-06-04 |
Find all providers in zip 30233 |
Taxonomy Code | 208VP0014X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pain Medicine |
Specialization | Interventional Pain Medicine |
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083194237 | Spectrum Pain Clinics Inc. | Pain Medicine | 23 Sandstone Cir, Jackson, TN 38305-2073 | 2018-08-17 |
1982141123 | W.a. Foote Memorial Hospital, Inc | Pain Medicine | 205 N. East Ave, Jackson, MI 49201 | 2017-01-26 |
1750789947 | Select Interventional Pain, PC | Pain Medicine | 794 Mcdonough Rd, Suite 108, Jackson, GA 30233-1572 | 2014-12-20 |
1124452859 | St Dominic Medical Associates LLC | Pain Medicine | 970 Lakeland Dr, Suite 45, Jackson, MS 39216-4635 | 2013-08-29 |
1548522774 | Neuropathy and Pain Centers of America Holding Company, LLC | Pain Medicine | 300 W Washington Ave, Ste. 250, Jackson, MI 49201-2180 | 2012-06-13 |
1932334828 | Advanced Pain Treatment Centers, PC | Pain Medicine | 60 Lynoak Cv, Jackson, TN 38305-2800 | 2009-05-20 |
1003025412 | Dr. Jeff Summers Pa | Pain Medicine | 1 Layfair Dr, Ste400, Jackson, MS 39232-9717 | 2007-05-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891302998 | Apollo Spine and Pain Center | Pain Medicine | 4415 Front Nine Dr, Cumming, GA 30041-6063 | 2020-09-23 |
1235756792 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 2100 Central Ave Ste 6, Augusta, GA 30904-6709 | 2020-07-01 |
1902433147 | Sun Pain Institute LLC | Pain Medicine | 836 E 65th St Ste 38, Savannah, GA 31405-4495 | 2020-03-26 |
1679107338 | Atlanta Interventional Pain Management, LLC | Pain Medicine | 13190 Highway 92 Ste 120, Woodstock, GA 30188-4406 | 2020-03-02 |
1578193355 | Regenerative Spine and Pain Specialists | Pain Medicine | 874 Lanier Ave W Ste 250, Fayetteville, GA 30214-7662 | 2020-01-22 |
1437790839 | Specialty Spine and Pain, PC | Pain Medicine | 1498 Jesse Jewell Pkwy Se Ste D, Gainesville, GA 30501-3874 | 2019-10-07 |
1154962165 | Specialty Spine and Pain, PC | Pain Medicine | 2695 Old Winder Hwy Ste 150, Braselton, GA 30517-6076 | 2019-10-01 |
1659912665 | Specialty Spine and Pain, PC | Pain Medicine | 5005a Lanier Islands Pkwy Ste 100, Buford, GA 30518-1802 | 2019-10-01 |
1114578515 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 6002 Highway 53 E Ste 110, Dawsonville, GA 30534-6227 | 2019-09-26 |
1477106771 | Spine Center of Southeast Georgia LLC | Pain Medicine | 52a Lindsey Lane, Kingsland, GA 31548-6855 | 2019-07-17 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.