Gannon, Brian Scott

Gannon, Brian Scott is an individual health care provider with primary practice located at 850 Peter Bryce Blvd , Tuscaloosa AL 35401-7419. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Gannon, Brian Scott can be contacted via phone (205) 348-1304.

Contact Information

Primary practice address
850 Peter Bryce Blvd Tuscaloosa AL 35401-7419
Phone: (205) 348-1304
Fax: (205) 348-7988
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 40582 Kentucky
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD30442 Tennessee
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 32891 Alabama

Profile Details

NPI number 1912992678
LBN Legal business name Gannon, Brian Scott
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2005
Last updated Jul 21st, 2022 - about 3 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 1912992678 NPPES
Tennessee MEDICAID 3830971
Tennessee MEDICAID 64122582

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