Provider Demographics
NPI:1144315771
Name:GALLA, CATHERINE R (MD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:R
Last Name:GALLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CADIZ
Mailing Address - State:KY
Mailing Address - Zip Code:42211-6125
Mailing Address - Country:US
Mailing Address - Phone:270-215-5922
Mailing Address - Fax:270-713-0420
Practice Address - Street 1:263 MAIN ST
Practice Address - Street 2:
Practice Address - City:CADIZ
Practice Address - State:KY
Practice Address - Zip Code:42211
Practice Address - Country:US
Practice Address - Phone:270-215-5922
Practice Address - Fax:270-713-0420
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY31208207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64312085Medicaid
KYG87784Medicare UPIN