Provider Demographics
NPI:1093134413
Name:GALLAGHER, CAITLIN C (MD)
Entity Type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:C
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CAITLIN
Other - Middle Name:COLLEEN
Other - Last Name:GALLAGHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2525 E BROADWAY ST STE 201
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-8049
Mailing Address - Country:US
Mailing Address - Phone:406-447-2885
Mailing Address - Fax:406-447-2883
Practice Address - Street 1:2525 E BROADWAY ST STE 201
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-8049
Practice Address - Country:US
Practice Address - Phone:406-447-2885
Practice Address - Fax:406-447-2883
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MTMED-PHYS-LIC-56360208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty