| NPI | 1396911558 |
|---|---|
| Doing Business As | LEGACY MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | WAYNE D THOMPSON CFO 985-624-7401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2014-05-23 |