Family Medicine
LEGACY FAMILY MEDICINE LLC
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1265172399 · enumerated 2022-03-29 · record updated 2022-03-29. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: BRETT HARTLINE, Administrator · (480) 498-9086
Addresses and phones
- Mailing address PO BOX 402, LUPTON, AZ, 86508-1402 Google Maps Apple Maps OpenStreetMap
- Practice location 1808 E AZTEC AVE STE 6, GALLUP, NM, 87301-4946 (505) 863-9374 Google Maps Apple Maps OpenStreetMap
Specialties
- Family Medicine 207Q00000X · Primary
In this directory
Locations and evidence
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Practice location
GALLUP, NM, 873014946
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.