Active NPI
William H Gallmann III, M.D.
- Diagnostic Radiology Physician
- Shreveport, LA
National Provider Identifier
1508880485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- MD15783
- Practice address
- 1453 E Bert Kouns Industrial Loop
Radiology
Shreveport, LA 71105-6800 - Phone
- (318) 681-4347
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD15783 | LA | Primary |
Addresses
Primary practice location
1453 E Bert Kouns Industrial Loop
Radiology
Shreveport, LA 71105-6800
Mailing address
PO Box 9600
Dept 09-038
Texarkana, TX 75505-9600
Phone (877) 498-1450
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1308161 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD15783 | LA | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391299200000",
"number": "1508880485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9600",
"address_2": "DEPT 09-038",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755059600",
"telephone_number": "877-498-1450",
"fax_number": "918-664-6120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1453 E BERT KOUNS INDUSTRIAL LOOP",
"address_2": "RADIOLOGY",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711056800",
"telephone_number": "318-681-4347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLMANN",
"first_name": "WILLIAM",
"middle_name": "H",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2014-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "LA",
"license": "MD15783",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1308161",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.