Provider Demographics
NPI:1871605790
Name:LEGAN, JAMES B (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:LEGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:401 15TH AVE S #201
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405
Mailing Address - Country:US
Mailing Address - Phone:406-727-2121
Mailing Address - Fax:406-727-2147
Practice Address - Street 1:401 15TH AVE S STE 201
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4334
Practice Address - Country:US
Practice Address - Phone:406-727-2121
Practice Address - Fax:406-727-2147
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT7389207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0099489Medicaid
MTF57413Medicare UPIN
MT010000589Medicare Oscar/Certification