Individual
ELIZABETH DENISE GALLEGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 769-9797
(225) 769-4228
Mailing address
7777 HENNESSY BLVD, SUITE 110, BATON ROUGE, LA 70808-4300
(225) 769-7979
(225) 769-4228
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G069197
CA
207R00000X
Internal Medicine Physician
ME0070878
FL
207U00000X
Nuclear Medicine Physician
Primary
13364R
LA
207U00000X
Nuclear Medicine Physician
16977
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568741
—
LA
Enumeration date
09/25/2006
Last updated
04/21/2011
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