Provider Demographics
NPI:1578874749
Name:BARDEN, GALA MARKIA (MD)
Entity Type:Individual
Prefix:DR
First Name:GALA
Middle Name:MARKIA
Last Name:BARDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:965 RIDGE LAKE BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-9446
Mailing Address - Country:US
Mailing Address - Phone:901-227-3255
Mailing Address - Fax:901-227-8591
Practice Address - Street 1:6027 WALNUT GROVE RD STE 319
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2128
Practice Address - Country:US
Practice Address - Phone:901-226-3882
Practice Address - Fax:901-226-3883
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX549694208600000X
TN57585208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty