Healthcare Provider Details

I. General information

NPI: 1437186178
Provider Name (Legal Business Name): DANIEL JAMES GALLAGHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 02/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4633 WICHERS DR
MARRERO LA
70072-3064
US

IV. Provider business mailing address

4633 WICHERS DR
MARRERO LA
70072-3064
US

V. Phone/Fax

Practice location:
  • Phone: 504-347-5421
  • Fax: 504-378-9331
Mailing address:
  • Phone: 504-347-5421
  • Fax: 504-378-9331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number020847
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: