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Contact Information

COLLEEN L GALLIMORE, PAC
3401 W GORE BLVD
LAWTON, OK73505
 Phone: 580-357-4339
 Fax: 580-357-4423
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for COLLEEN L GALLIMORE · (Female)

NPI # 1346220415
Status Active
Credentials PAC
Entity Individual
Enumeration date 01/17/2006
Last updated 08/01/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • OK License # APA1505
  • OK Medicaid 200073860A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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