Provider Demographics
NPI:1114156130
Name:GALLAGHER, KRISTALYN K (DO)
Entity Type:Individual
Prefix:DR
First Name:KRISTALYN
Middle Name:K
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:170 MANNING DR
Mailing Address - Street 2:CB#7213
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7213
Mailing Address - Country:US
Mailing Address - Phone:919-966-4416
Mailing Address - Fax:919-966-8806
Practice Address - Street 1:170 MANNING DR
Practice Address - Street 2:CB#7213
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7213
Practice Address - Country:US
Practice Address - Phone:919-966-4416
Practice Address - Fax:919-966-8806
Is Sole Proprietor?:No
Enumeration Date:2009-07-12
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK4760208600000X
ARE-8087208600000X
NC2014-020392086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery