=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881037059
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JACK C GALAGAN M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/08/2013
-----------------------------------------------------
Last Update Date | 12/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9300 DEWITT LOOP
-----------------------------------------------------
City | FT BELVOIR
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22060-5285
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 571-231-4863
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9300 DEWITT LOOP
-----------------------------------------------------
City | FT BELVOIR
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22060-5285
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 571-231-4863
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 116277
-----------------------------------------------------
License Number State | AK
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | MD-20750
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 0101257355
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | 0101257355
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 207RS0012X
-----------------------------------------------------
Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number | 010125755
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------