Provider Demographics
NPI:1194773689
Name:GALLIGAN, JOHN DONALD (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DONALD
Last Name:GALLIGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6265 ROCK CHALK DR
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049
Mailing Address - Country:US
Mailing Address - Phone:785-843-9125
Mailing Address - Fax:785-843-3176
Practice Address - Street 1:6265 ROCK CHALK DR
Practice Address - Street 2:SUITE 1500
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049
Practice Address - Country:US
Practice Address - Phone:785-843-9125
Practice Address - Fax:785-843-3176
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE23606207X00000X, 207XX0004X
IA38251207X00000X
KS0430547207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025387000Medicaid
NE10025238600Medicaid
NE47068731751Medicaid
NE47602554420Medicaid
NE47602554412Medicaid
NE10025238600Medicaid
NE10025387000Medicaid