Glenn G Gailis, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD08780 Issued in OR

Practice address

1905 Main St
Klamath Falls, OR 97601-2638

Phone

(541) 882-4691

Fax

(541) 883-5211

NPI assigned

Mar 8, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1790816189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 MAIN ST",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976012638",
            "telephone_number": "541-882-4691",
            "fax_number": "541-883-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 MAIN ST",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976012638",
            "telephone_number": "541-882-4691",
            "fax_number": "541-883-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAILIS",
        "first_name": "GLENN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD08780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "239756",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Future Hope Wellness LLC
• Zenaida Lucas Gabriel
• Arden Jay Gage Jr., P.A.
• Eli John Gahringer
• Daniel Paul Gailis, DMD
• Heidi Noel Gaither, LCSW
• Kristi Gallagher
• Stacey Annette Gallagher
• Tara Gallagher
• Tatiana Gallery, CCMA

• Family Medicine Physician in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.