Organization
SUSAN N. LEGACY, MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN N LEGACY MD (PHYSICIAN OWNER)
(802) 876-4000
Entity
Organization
Contact information
Practice address
188 ALLEN BROOK LN, WILLISTON, VT 05495-9303
(802) 876-4000
(802) 876-4001
Mailing address
188 ALLEN BROOK LN, WILLISTON, VT 05495-9303
(802) 876-4000
(802) 876-4001
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010298
—
VT
Enumeration date
01/09/2007
Last updated
08/22/2020
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