Individual
ANTHONY GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 W JEFFERSON ST, SUITE C, FRANKLIN, IN 46131-9120
(317) 736-8474
(317) 736-6040
Mailing address
1300 W JEFFERSON ST, SUITE C, FRANKLIN, IN 46131-9120
(317) 736-8474
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01023878
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100220010
—
IN
Enumeration date
11/01/2006
Last updated
04/21/2010
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