Provider Demographics
NPI:1104968403
Name:LEGGETT, RICHARD PRESTON (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:PRESTON
Last Name:LEGGETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 HEALTH PARK DR FL HP2
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4692
Mailing Address - Country:US
Mailing Address - Phone:615-373-7600
Mailing Address - Fax:866-346-1426
Practice Address - Street 1:1906 BRAEBURN DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-7304
Practice Address - Country:US
Practice Address - Phone:540-444-0460
Practice Address - Fax:540-444-0479
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010497562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA073020OtherANTHEM BCBS
VA023707OtherVALUE OPTIONS
VAC60277Medicare UPIN