Provider Demographics
NPI:1508006248
Name:MCGALLIARD, AMOS TROY (RN)
Entity Type:Individual
Prefix:
First Name:AMOS
Middle Name:TROY
Last Name:MCGALLIARD
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BEMISTON AVE
Mailing Address - Street 2:
Mailing Address - City:TALLADEGA
Mailing Address - State:AL
Mailing Address - Zip Code:35160-3289
Mailing Address - Country:US
Mailing Address - Phone:256-362-9254
Mailing Address - Fax:256-480-1472
Practice Address - Street 1:7 BEMISTON AVE
Practice Address - Street 2:
Practice Address - City:TALLADEGA
Practice Address - State:AL
Practice Address - Zip Code:35160-3289
Practice Address - Country:US
Practice Address - Phone:256-362-9254
Practice Address - Fax:256-480-1472
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-075840163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse