Provider Demographics
NPI:1467725192
Name:GALLUCCI, RONALD GARY (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:GARY
Last Name:GALLUCCI
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 1:45359 W NORRIS RD
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85139-9142
Mailing Address - Country:US
Mailing Address - Phone:480-300-4225
Mailing Address - Fax:949-891-7886
Practice Address - Street 1:45359 W NORRIS RD
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85139-9142
Practice Address - Country:US
Practice Address - Phone:480-300-4225
Practice Address - Fax:480-264-8527
Is Sole Proprietor?:No
Enumeration Date:2012-02-10
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ47679208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice