Healthcare Provider Details

I. General information

NPI: 1710113345
Provider Name (Legal Business Name): DAVID KIRK GALLEGOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2009
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 SAINT MICHAELS DR STE A104
SANTA FE NM
87505-7672
US

IV. Provider business mailing address

1620 N MAIN ST
SPANISH FORK UT
84660-1008
US

V. Phone/Fax

Practice location:
  • Phone: 855-817-4687
  • Fax: 866-913-0013
Mailing address:
  • Phone: 435-559-1008
  • Fax: 866-913-0013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD2018-0835
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: