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

Legacy Medical LLC

Organization Adult Medicine Physician · NPI 1619594637

Legacy Medical LLC is an Adult Medicine Physician in Bismarck, North Dakota. Registered with an NPI since 2020.

In the registry since
2020
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

600 S 2nd St Ste 200
Bismarck, ND 58504-5729
Phone: (701) 516-4637
Fax: (877) 651-1381
Show map & directions

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

Specialties & licences

Adult Medicine Physician (primary) Taxonomy 207QA0505X

Record details

NPI number1619594637
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jill Wilson — Chief Operating Officer · (701) 516-4637
NPI enumeratedJune 26, 2020
Last updated in NPPESMarch 3, 2023
Certification dateMarch 3, 2023
Mailing addressPo Box 13238, Grand Forks, ND 58208-3238