Provider Demographics
NPI:1689670622
Name:GALUSHA, J HARLEY (DO)
Entity Type:Individual
Prefix:DR
First Name:J
Middle Name:HARLEY
Last Name:GALUSHA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:6140 S MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-1933
Mailing Address - Country:US
Mailing Address - Phone:918-252-2020
Mailing Address - Fax:918-252-7466
Practice Address - Street 1:3233 E 31ST ST
Practice Address - Street 2:STE 202
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-2446
Practice Address - Country:US
Practice Address - Phone:918-743-9494
Practice Address - Fax:918-743-9698
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2008-03-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK1111207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK180036310OtherRR MEDICARE
OKCO5028OtherRR MEDICARE
OK100092190AMedicaid
OK180036310OtherRR MEDICARE
OK100092190AMedicaid