Provider Demographics
NPI:1740553437
Name:KATS-KAGAN, GALINA
Entity type:Individual
Prefix:DR
First Name:GALINA
Middle Name:
Last Name:KATS-KAGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GALINA
Other - Middle Name:
Other - Last Name:KHORAYCHUK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2931 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32446-3447
Mailing Address - Country:US
Mailing Address - Phone:850-526-7177
Mailing Address - Fax:850-526-7177
Practice Address - Street 1:5168 EZELL RD
Practice Address - Street 2:
Practice Address - City:GRACEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32440-2402
Practice Address - Country:US
Practice Address - Phone:850-263-5500
Practice Address - Fax:850-263-1564
Is Sole Proprietor?:No
Enumeration Date:2012-02-12
Last Update Date:2012-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME71267207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine