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NPI Code Detail

MEDICARE: DR. KEVIN L GALLOWAY V DO

MEDICARE: DR. KEVIN L GALLOWAY V DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician16585MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073507547
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN L GALLOWAY V DO
Provider Business Mailing Address
First Line : PO BOX 6004
Second Line :
City : URBANA
State : IL
Zip : 61803-6004
Country : US
Telephone Number : 217-383-6792
Fax Number :
Provider Business Practice Location Address
First Line : 1860 CHADWICK DR
Second Line : SUITE 300
City : JACKSON
State : MS
Zip : 39204-3463
Country : US
Telephone Number : 601-376-2999
Fax Number : 601-376-2989
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2005
Last Update Date : 07/01/2015

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Directions to “ DR. KEVIN L GALLOWAY V DO” Practice Location

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