Provider Demographics
NPI:1235331349
Name:GALEGOR, WILLIAM BAKER II (PA-C (MPAS))
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:BAKER
Last Name:GALEGOR
Suffix:II
Gender:M
Credentials:PA-C (MPAS)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:217 GREENBRIAR RD
Mailing Address - Street 2:
Mailing Address - City:KINGSLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31548-5403
Mailing Address - Country:US
Mailing Address - Phone:860-389-5508
Mailing Address - Fax:
Practice Address - Street 1:NMRTC JACKSONVILLE 2080 CHILD STREET
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32214-2575
Practice Address - Country:US
Practice Address - Phone:904-542-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9112974363A00000X
NC0010-07735363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant