Provider Demographics
NPI:1427349984
Name:GALLAGHER, JOEL LOUIS (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:LOUIS
Last Name:GALLAGHER
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 1:300 E WENDOVER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1229
Mailing Address - Country:US
Mailing Address - Phone:336-663-5220
Mailing Address - Fax:
Practice Address - Street 1:2509 RICHARDSON DR STE C
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-5926
Practice Address - Country:US
Practice Address - Phone:336-342-0922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2025-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-00582207K00000X
WI62452207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1427349984Medicaid
WI1427349984Medicaid