Gannaway, Robert A.

Gannaway, Robert A. is an sole proprietor health care provider with primary practice located at 408 E Railroad Ave Suite B, Crystal Springs MS 39059-2520. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gannaway, Robert A. can be contacted via phone (601) 892-7860.

Contact Information

Primary practice address
408 E Railroad Ave Suite B Crystal Springs MS 39059-2520
Phone: (601) 892-7860
Fax: (601) 892-7861
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 12331 Mississippi

Profile Details

NPI number 1649227745
LBN Legal business name Gannaway, Robert A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 27th, 2006
Last updated Sep 16th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649227745 NPPES
Mississippi MEDICAID 01529794

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