Provider Demographics
NPI:1225294440
Name:A. FREDERICK GALL, JR. MD PLC
Entity Type:Organization
Organization Name:A. FREDERICK GALL, JR. MD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:A.
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:GALL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:540-542-0054
Mailing Address - Street 1:1104 AMHERST ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3340
Mailing Address - Country:US
Mailing Address - Phone:540-542-0054
Mailing Address - Fax:
Practice Address - Street 1:1104 AMHERST ST
Practice Address - Street 2:SUITE 100
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3340
Practice Address - Country:US
Practice Address - Phone:540-542-0054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237397208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty