Individual
JESSICA D GALLAGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
302 W MAIN ST, FAIRBORN, OH 45324-5037
(937) 281-4673
Mailing address
100 CROWNE POINT PL, CINCINNATI, OH 45241-5427
(513) 743-7628
(513) 737-1107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35077307
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000387041
ANTHEM
OH
05
—
2247401
—
OH
01
—
P00432941
RAILROAD MEDICARE
OH
Enumeration date
11/07/2006
Last updated
10/30/2023
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