Provider Demographics
NPI:1437186178
Name:GALLAGHER, DANIEL JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JAMES
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4633 WICHERS DR
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-3064
Mailing Address - Country:US
Mailing Address - Phone:504-347-5421
Mailing Address - Fax:504-378-9331
Practice Address - Street 1:4633 WICHERS DR
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3064
Practice Address - Country:US
Practice Address - Phone:504-347-5421
Practice Address - Fax:504-378-9331
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA020847207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAF37061Medicare UPIN