Healthcare Provider Details

I. General information

NPI: 1902884182
Provider Name (Legal Business Name): THOMAS JOSEPH GAL JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 S LIMESTONE B317 EAR NOSE AND THROAT
LEXINGTON KY
40536-0001
US

IV. Provider business mailing address

740 S. LIMESTONE B317 EAR, NOSE AND THROAT CLINIC
LEXINGTON KY
40536-0284
US

V. Phone/Fax

Practice location:
  • Phone: 859-257-5405
  • Fax: 859-257-4644
Mailing address:
  • Phone: 859-257-5405
  • Fax: 859-257-4488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number18540
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number40491
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: