Gannon, Charles Sanford
Gannon, Charles Sanford is an sole proprietor health care provider with primary practice located at 1645 N. Alvernon Way #1 , Tucson AZ 85712. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Gannon, Charles Sanford can be contacted via phone (520) 881-7474.Contact Information
Primary practice address
1645 N. Alvernon Way #1
Tucson AZ 85712
Phone: (520) 881-7474
Fax: (520) 881-0676
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 6156 | Arizona |
Profile Details
| NPI number | 1053303024 |
|---|---|
| LBN Legal business name | Gannon, Charles Sanford |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 16th, 2005 |
| Last updated | May 3rd, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053303024 | NPPES |
| Arizona | MEDICAID | 221193 |
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