Gantt, Pickens A.

Gantt, Pickens A. is an individual health care provider with primary practice located at 830 Pennsylvania Ave Suite 205, Charleston WV 25302-3302. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Reproductive Endocrinology. Allopathic & Osteopathic Physicians / Reproductive Endocrinology is his primary health care specialty. Gantt, Pickens A. can be contacted via phone (304) 388-2863.

Contact Information

Primary practice address
830 Pennsylvania Ave Suite 205 Charleston WV 25302-3302
Phone: (304) 388-2863
Fax: (304) 388-2866
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 13100 Tennessee
Allopathic & Osteopathic Physicians / Reproductive Endocrinology 207VE0102X 22945 West Virginia

Profile Details

NPI number 1063519445
LBN Legal business name Gantt, Pickens A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Dec 14th, 2015 - about 9 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 1063519445 NPPES
West Virginia MEDICAID 3810010685

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