Provider Demographics
NPI:1689053118
Name:GALLIGAR, BILLY J (MD)
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:J
Last Name:GALLIGAR
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 1:808 N WHITLEY DR
Mailing Address - Street 2:
Mailing Address - City:FRUITLAND
Mailing Address - State:ID
Mailing Address - Zip Code:83619-2437
Mailing Address - Country:US
Mailing Address - Phone:208-452-2672
Mailing Address - Fax:208-452-2673
Practice Address - Street 1:808 N WHITLEY DR
Practice Address - Street 2:
Practice Address - City:FRUITLAND
Practice Address - State:ID
Practice Address - Zip Code:83619-2437
Practice Address - Country:US
Practice Address - Phone:208-452-2672
Practice Address - Fax:208-452-2673
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-13499207QH0002X
IDMRM-1473207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine