Individual
BRIAN J GALLAGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1103 W LIBERTY ST, FARMINGTON, MO 63640-1921
(573) 756-6751
(573) 756-6807
Mailing address
1103 W LIBERTY ST, FARMINGTON, MO 63640-1921
(573) 756-6751
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
R8J31
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
247857105
—
MO
Enumeration date
08/23/2006
Last updated
02/11/2021
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