Provider Demographics
NPI:1215921069
Name:GALANIS, JOHN
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:GALANIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7331 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-4405
Mailing Address - Country:US
Mailing Address - Phone:314-633-8575
Mailing Address - Fax:314-743-8399
Practice Address - Street 1:7331 WATSON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-4405
Practice Address - Country:US
Practice Address - Phone:314-633-8575
Practice Address - Fax:314-743-8399
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO36602207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA14018Medicare UPIN
MO015013352Medicare ID - Type Unspecified
MO3992040001Medicare NSC