Provider Demographics
NPI:1356452320
Name:GALLAGHER, JAMES D (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3890 TAMPA RD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3676
Mailing Address - Country:US
Mailing Address - Phone:727-786-8678
Mailing Address - Fax:727-786-6229
Practice Address - Street 1:3890 TAMPA RD
Practice Address - Street 2:SUITE 401
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3676
Practice Address - Country:US
Practice Address - Phone:727-786-8678
Practice Address - Fax:727-786-6229
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME80813207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH53056Medicare UPIN