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Organization
ROBERT A. GANNAWAY, M.D., PLLC
Active
Organization
ROBERT A. GANNAWAY, M.D., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT A. GANNAWAY M.D. (PHYSICIAN)
(601) 892-7860
Entity
Organization
Contact information
Practice address
408 E RAILROAD AVE, SUITE B, CRYSTAL SPRINGS, MS 39059-2520
(601) 892-7860
(601) 892-7861
Mailing address
408 E RAILROAD AVE, SUITE B, CRYSTAL SPRINGS, MS 39059-2520
(601) 892-7860
(601) 892-7861
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12331
MS
Other
Enumeration date
07/11/2006
Last updated
08/22/2020
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