Healthcare Provider Details

I. General information

NPI: 1386848836
Provider Name (Legal Business Name): JOHN E. GALLEHR, MD P.S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 06/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8013 NEW LAGRANGE RD SUITE # 1
LOUISVILLE KY
40222-4700
US

IV. Provider business mailing address

8013 NEW LAGRANGE RD SUITE # 1
LOUISVILLE KY
40222-4700
US

V. Phone/Fax

Practice location:
  • Phone: 502-727-7759
  • Fax:
Mailing address:
  • Phone: 502-727-7759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number29766
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number29766
License Number StateKY

VIII. Authorized Official

Name: DR. JOHN ERIC GALLEHR
Title or Position: PRESIDENT
Credential: M.D.
Phone: 502-727-7759