Provider Demographics
NPI:1235264896
Name:MICHAEL S. GALLOWAY
Entity Type:Organization
Organization Name:MICHAEL S. GALLOWAY
Other - Org Name:CUMBERLAND EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE AND BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:LANGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-484-3344
Mailing Address - Street 1:57 FAIRFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38558-4417
Mailing Address - Country:US
Mailing Address - Phone:931-484-3344
Mailing Address - Fax:931-456-3671
Practice Address - Street 1:57 FAIRFIELD BLVD
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38558-4417
Practice Address - Country:US
Practice Address - Phone:931-484-3344
Practice Address - Fax:931-456-3671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD024999207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3376762Medicare ID - Type Unspecified
TN3905700001Medicare NSC