Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | OS 8251 | FL |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | OS 8251 | FL |
NPI | 1093883357 |
---|---|
Provider Name | Karen Fechter Leggett |
First Address | Trenton, FL 32693-5003 |
Second Address | Sarasota, FL 34231-2406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2006 |
Last Update Date | 25/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H30043 | (02) | FL |