Dr. Roan Sumner Gannon, M.D.
Family Medicine in Albertville, AL. Individual provider (NPI-1).
NPI number1548529902
StatusActive
Last updated in NPPESApr 23, 2015
Details
- NPI
- 1548529902
- Entity type
- Individual (NPI-1)
- Name
- Dr. Roan Sumner Gannon
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 4, 2012
- Last updated
- Apr 23, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 33074 | AL | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
5104 Us Highway 431Albertville, AL 35950-0237
Phone 256-878-8180 · Fax 256-891-3693
Mailing address
5104 Us Highway 431Albertville, AL 35950-0237
Phone 256-878-8180 · Fax 256-891-3693
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