Provider Demographics
NPI:1609841154
Name:LEGERE, ARTHUR GEORGE III (DC)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:GEORGE
Last Name:LEGERE
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 W BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:PA
Mailing Address - Zip Code:18938-1431
Mailing Address - Country:US
Mailing Address - Phone:215-862-5028
Mailing Address - Fax:215-862-5029
Practice Address - Street 1:364 W BRIDGE ST
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:PA
Practice Address - Zip Code:18938-1431
Practice Address - Country:US
Practice Address - Phone:215-862-5028
Practice Address - Fax:215-862-5029
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002939-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2749452OtherAETNA- HMO
PA0023247000OtherPERSONAL CHOICE
PA0004263059OtherAETNA-PPO
PALE71607Medicare ID - Type Unspecified