Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 4699 | AL |
Y | 213EG0000X | General Practice | 4699 | AL |
NPI | 1003910399 |
---|---|
Provider Name | Dr. David W. Gann |
First Address | Marion, AL 36756-1020 |
Second Address | Marion, AL 36756 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009940815 | (05) | AL |