Provider Demographics
NPI:1629053152
Name:GALLET, BERTRAND LAURENT (MD)
Entity Type:Individual
Prefix:DR
First Name:BERTRAND
Middle Name:LAURENT
Last Name:GALLET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8000W 110TH ST 150
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2382
Mailing Address - Country:US
Mailing Address - Phone:913-599-6777
Mailing Address - Fax:913-599-3955
Practice Address - Street 1:8000 W 110TH ST
Practice Address - Street 2:SUITE 150
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2338
Practice Address - Country:US
Practice Address - Phone:913-599-6777
Practice Address - Fax:913-599-3955
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-224422085R0202X
MOR2H862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology