Individual
KENNETH J GARGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3949 S COBB DR SE, SMYRNA, GA 30080-6342
(770) 434-0710
Mailing address
PO BOX 2994, KENNESAW, GA 30156-9181
(770) 779-2171
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
055363
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
330297184
—
GA
Enumeration date
05/22/2006
Last updated
07/10/2008
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