Healthcare Provider Details
I. General information
NPI: 1023105137
Provider Name (Legal Business Name): MARTIN GALLAGHER MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/09/2006
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3601 TVC
NASHVILLE TN
37232-0001
US
IV. Provider business mailing address
3841 GREEN HILLS VILLAGE DR STE 200
NASHVILLE TN
37215-2691
US
V. Phone/Fax
- Phone: 615-322-3000
- Fax:
- Phone: 615-936-2000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | MD36237 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084E0001X |
| Taxonomy | Epilepsy Physician |
| License Number | 36237 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: