Healthcare Provider Details

I. General information

NPI: 1013164623
Provider Name (Legal Business Name): LEGACY MEDICAL CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2008
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3540 WASHINGTON RD
MC MURRAY PA
15317-2957
US

IV. Provider business mailing address

3540 WASHINGTON RD
MC MURRAY PA
15317-2957
US

V. Phone/Fax

Practice location:
  • Phone: 724-941-0707
  • Fax:
Mailing address:
  • Phone: 724-941-0707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberMD451022
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC009236
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. THOMAS JOSEPH BURNETT
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 724-941-0707