Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | MED-PHYS-LIC-95952 | MT |
NPI | 1043604945 |
---|---|
Provider Name | Thomas Mitchell Gallagher |
First Address | Billings, MT 59102-1736 |
Second Address | Billings, MT 59102-1736 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2015 |
Last Update Date | 19/08/2021 |