Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Legacy Family Medicine LLC

Organization Family Medicine Physician · NPI 1265172399

Legacy Family Medicine LLC provides Family Medicine Physician services in Gallup, New Mexico. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1808 E Aztec Ave Ste 6
Gallup, NM 87301-4946
Phone: (505) 863-9374
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1265172399
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brett Hartline — Administrator · (480) 498-9086
NPI enumeratedMarch 29, 2022
Last updated in NPPESMarch 29, 2022
Certification dateMarch 29, 2022
Mailing addressPo Box 402, Lupton, AZ 86508-1402

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