MEDICARE: DR. JAMES LAWRENCE GALLAGHER MD FAPA

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
1	2084F0202X	Forensic Psychiatry Physician	23610	IA
2	2084P0800X	Psychiatry Physician	23610	IA
3	2084P0800X	Psychiatry Physician	20601	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20562	OTHER	IA	WELLMARK

General Provider Information

NPI Number	:	1487648143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES LAWRENCE GALLAGHER MD FAPA

Provider Business Mailing Address
First Line	:	1000 73RD ST
Second Line	:	SUITE 5
City	:	WINDSOR HEIGHTS
State	:	IA
Zip	:	50311-1321
Country	:	US
Telephone Number	:	515-222-1175
Fax Number	:	515-222-0953

Provider Business Practice Location Address
First Line	:	1000 73RD ST
Second Line	:	SUITE 5
City	:	WINDSOR HEIGHTS
State	:	IA
Zip	:	50311-1321
Country	:	US
Telephone Number	:	515-222-1175
Fax Number	:	515-222-0953

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	09/11/2025

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