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General NPI Number Information
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NPI Number | 1659554392
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Entity Type | Organization
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Legal Business Name | DARKE COUNTY OBSTETRICS AND GYNECOLOGY
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Dates
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Enumeration Date | 12/17/2007
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Last Update Date | 12/17/2007
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Provider Practice Location Address
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Address Line | 804 CENTRAL AVE
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City | GREENVILLE
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State | OH
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Zip | 45331-1206
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Country | US
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Telephone | 937-548-3880
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Fax | 937-222-7255
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Provider Business Mailing Address
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Address Line | PO BOX 1116
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City | GREENVILLE
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State | OH
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Zip | 45331-9116
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Country | US
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Telephone | 937-548-3880
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Fax | 937-222-7255
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL LEE GALLOWAY
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Credential | D.O.
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Telephone | 937-548-3880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 34006095
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License Number State | OH
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