Provider Demographics
NPI:1508846957
Name:GALLAGHER, JOHN TIMOTHY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:TIMOTHY
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 105
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-0105
Mailing Address - Country:US
Mailing Address - Phone:215-355-1155
Mailing Address - Fax:215-355-7345
Practice Address - Street 1:1205 LANGHORNE NEWTOWN RD
Practice Address - Street 2:SUITE102
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1219
Practice Address - Country:US
Practice Address - Phone:215-757-3635
Practice Address - Fax:215-757-3999
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA030244E207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA231886180OtherHORIZON BC/BS OF NJ
PA231886180OtherAARP
PA92699OtherAETNA
PA55219OtherAETNA US HEALTHCARE
PA040003589OtherRAILROAD MEDICARE
PA137600OtherPREMIER BLUE
PA597157OtherBLUE CHOICE
PAGA137600OtherBC/BS OF PA
PA231886180OtherUNITED HEALTHCARE
PA231886180OtherIE SHAFFER
PAGA137600OtherAMERIHEALTH
PA082993000OtherKEYSTONE HEALTHPLAN EAST
PA137600OtherBC/BS PERSONAL CHOICE
PA231886180OtherGREAT WEST
PA231886180OtherMULTIPLAN
PA231886180OtherTRICARE
PA231886180OtherPHCS
PA231886180OtherMULTIPLAN
PA55219OtherAETNA US HEALTHCARE