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General NPI Number Information
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NPI Number | 1235331349
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Entity Type | Individual
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Provider Name | WILLIAM BAKER GALEGOR II PA-C (MPAS)
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Gender | Male
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | NMRTC JACKSONVILLE 2080 CHILD STREET
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City | JACKSONVILLE
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State | FL
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Zip | 32214-2575
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Country | US
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Telephone | 904-542-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 217 GREENBRIAR RD
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City | KINGSLAND
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State | GA
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Zip | 31548-5403
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Country | US
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Telephone | 860-389-5508
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9112974
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-07735
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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