Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Legacy Family Medicine LLC

Organization Family Medicine Physician · NPI 1265172399

Legacy Family Medicine LLC is a Family Medicine Physician 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.

See every abbreviation used in this directory →

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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