Provider Demographics
NPI:1831180983
Name:GALAN, VINCENT (MD)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:GALAN
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 1:1365 ROCK QUARRY RD STE 202
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-5023
Mailing Address - Country:US
Mailing Address - Phone:770-771-6580
Mailing Address - Fax:
Practice Address - Street 1:1365 ROCK QUARRY RD STE 202
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-5023
Practice Address - Country:US
Practice Address - Phone:770-771-6580
Practice Address - Fax:770-771-6589
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA28685207L00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00371291BMedicaid
GA050030318OtherRAILROAD MEDICARE
GA00371291BMedicaid
GA05BDBLSMedicare ID - Type UnspecifiedANESTHESIA