# DAVID G FANNEY, DO PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891075032
- **Authorized official:** DR. DAVID GRAFTON FANNEY D.O. (PRISIDENT)
- **Authorized official phone:** (386) 752-2246

## Contact information

- **Practice address:** 4241 NW AMERICAN LN, LAKE CITY, FL 32055-4881
- **Practice address phone:** (386) 752-2246
- **Practice address fax:** (386) 758-7998
- **Mailing address:** 4241 NW AMERICAN LN, LAKE CITY, FL 32055-4881
- **Mailing address phone:** (386) 752-2246
- **Mailing address fax:** (386) 758-7998

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | OS0005960 | FL | Yes |

## Other

- **Enumeration date:** 08/19/2011
- **Last updated:** 01/27/2012