Provider Demographics
NPI:1760460133
Name:GALE, DONALD H (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:H
Last Name:GALE
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:PO BOX 246
Mailing Address - Street 2:
Mailing Address - City:SNEEDVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37869-0246
Mailing Address - Country:US
Mailing Address - Phone:423-733-1191
Mailing Address - Fax:
Practice Address - Street 1:5052 W 4TH ST
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1069
Practice Address - Country:US
Practice Address - Phone:601-261-2587
Practice Address - Fax:601-261-3201
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA27593207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0065466Medicaid
E52151Medicare UPIN
IA0065466Medicaid