Gannon, Timothy Hugh
Gannon, Timothy Hugh is an individual health care provider with primary practice located at 4300 W Main St Suite 403, Dothan AL 36305-1054. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Gannon, Timothy Hugh can be contacted via phone (334) 793-4788.Contact Information
Primary practice address
4300 W Main St Suite 403
Dothan AL 36305-1054
Phone: (334) 793-4788
Fax: (334) 793-1561
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X |
Profile Details
| NPI number | 1083676852 |
|---|---|
| LBN Legal business name | Gannon, Timothy Hugh |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 5th, 2006 |
| Last updated | Apr 19th, 2017 - about 8 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 | 1083676852 | NPPES |
| Alabama | Other | 174017500 | US DEPT OF LAOBR |
| Alabama | MEDICAID | 000031973 | US DEPT OF LAOBR |
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