Healthcare Provider Details

I. General information

NPI: 1356807663
Provider Name (Legal Business Name): LMG, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2019
Last Update Date: 02/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19343 SUNSHINE AVE
COVINGTON LA
70433-5160
US

IV. Provider business mailing address

2600 BELLE CHASSE HWY STE I
TERRYTOWN LA
70056-7156
US

V. Phone/Fax

Practice location:
  • Phone: 985-892-5117
  • Fax:
Mailing address:
  • Phone: 504-391-7670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL JAMES GALLAGHER
Title or Position: OFFICER
Credential: MD
Phone: 504-391-7670