Organization
LEGACY MEDICAL SPECIALIST LLC
Active
Organization
LEGACY MEDICAL SPECIALIST LLC
Active
Other names
Legacy Medical Specialist LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE D CAGLEY (CEO)
(714) 421-9431
Entity
Organization
Contact information
Practice address
200 OAK ST NE STE 7-B, ALBUQUERQUE, NM 87106-4740
(505) 420-6979
Mailing address
200 OAK ST NE STE 7-B, ALBUQUERQUE, NM 87106-4740
(505) 420-6979
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
01/27/2022
Last updated
11/12/2024
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