Provider Demographics
NPI:1427946680
Name:LEGGETT PRIMARY CARE INC
Entity type:Organization
Organization Name:LEGGETT PRIMARY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEGGETT
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:386-265-1441
Mailing Address - Street 1:533 N NOVA RD STE 115
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-4421
Mailing Address - Country:US
Mailing Address - Phone:386-265-1441
Mailing Address - Fax:386-265-4066
Practice Address - Street 1:533 N NOVA RD STE 115
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-4421
Practice Address - Country:US
Practice Address - Phone:386-265-1441
Practice Address - Fax:386-265-4066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty