1497721872 NPI number — ALAN K GALLOWAY MD

Table of content: ALAN K GALLOWAY MD (NPI 1497721872)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497721872 NPI number — ALAN K GALLOWAY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GALLOWAY
Provider First Name:
ALAN
Provider Middle Name:
K
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497721872
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/28/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5301 VIRGINIA WAY
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-7541
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-695-4977
Provider Business Mailing Address Fax Number:
615-263-3348

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5301 VIRGINIA WAY
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
BRENTWOOD
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37027-7541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-695-4977
Provider Business Practice Location Address Fax Number:
615-263-3348
Provider Enumeration Date:
02/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0102X , with the licence number:  18850 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 166689000 . This is a "DOL" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 4011834 . This is a "BCBS OF TN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 64721426 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3828283 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1140413 . This is a "UHC" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 100020545 . This is a "PHP CARITEN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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