Healthcare Provider Details

I. General information

NPI: 1144315771
Provider Name (Legal Business Name): CATHERINE R GALLA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 05/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 MAIN ST
CADIZ KY
42211
US

IV. Provider business mailing address

263 MAIN ST
CADIZ KY
42211-6125
US

V. Phone/Fax

Practice location:
  • Phone: 270-215-5922
  • Fax: 270-713-0420
Mailing address:
  • Phone: 270-215-5922
  • Fax: 270-713-0420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number31208
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: