Gantt, Roddie R

Gantt, Roddie R is an individual health care provider with primary practice located at 201 Governors Dr Sw Ste 400 , Huntsville AL 35801-5183. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Gantt, Roddie R can be contacted via phone (256) 265-7246.

Contact Information

Primary practice address
201 Governors Dr Sw Ste 400 Huntsville AL 35801-5183
Phone: (256) 265-7246
Fax: (256) 265-7017
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X MD.17397 Alabama

Profile Details

NPI number 1912996059
LBN Legal business name Gantt, Roddie R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2005
Last updated Apr 10th, 2018 - about 6 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1912996059 NPPES
Alabama MEDICAID 000077987

Popular Providers