Dr. Matthew Michael Gannon
Internist Hospice and Palliative Medicine
500 W Thomas Rd Ste 600
Phoenix
, Arizona 85013-4221
Dr. Matthew Michael Gannon
Internist Hospice and Palliative Medicine
500 W Thomas Rd Ste 600
Phoenix
, Arizona 85013-4221
(916) 636-4358
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About
Features
Specialties
- Internist
- Hospice and Palliative Medicine
Languages spoken
- English
Location
First Address
- Dr. Matthew Michael Gannon
- Po Box 33269
- Phoenix, AZ
- Zip : 85067-3269
- Fax : (916) 636-4358
- Phone : (602) 406-4786
Second Address
- Dr. Matthew Michael Gannon
- 500 W Thomas Rd Ste 600
- Phoenix, AZ
- Zip : 85013-4221
- Fax : (602) 512-6545
- Phone : (602) 406-4433
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207R00000X | Internist | R10852 | IA |
| N | 111NI0900X | Internist | R10852 | IA |
| Y | 207RH0002X | Hospice and Palliative Medicine | 60565 | AZ |
National Provider Identifier
| NPI | 1285163246 |
|---|---|
| Provider Name | Dr. Matthew Michael Gannon |
| First Address | Phoenix, AZ 85067-3269 |
| Second Address | Phoenix, AZ 85013-4221 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/06/2017 |
| Last Update Date | 19/08/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.