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Individual

DR. GARY LYLE GALLAGHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
777 SW MILL VIEW WAY STE 250, BEND, OR 97702-1140
(541) 728-3184
Mailing address
2249 NW LAKESIDE PL, BEND, OR 97703-1354
(541) 728-3184

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
MD21961
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
134297
OR
Enumeration date
02/08/2007
Last updated
01/02/2020
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