Provider Demographics
NPI:1043248230
Name:GALLAGHER, DAVID DILLON (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:DILLON
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6105 HORIZON DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-1110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6105 HORIZON DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-1110
Practice Address - Country:US
Practice Address - Phone:812-376-9353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1035879207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100365100Medicaid
IN100365100Medicaid
IN000000195472OtherANTHEM
IN200040851OtherRAILROAD MEDICARE
IN000000195472OtherANTHEM
IN003714OtherSIHO
IN179050DMedicare PIN