Individual
HERBERT H GANNON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4300 WEST MAIN STREET, SUITE 31 WOMENS HEALTHCARE OF DOTHAN PC, DOTHAN, AL 36305-4300
(334) 793-6511
(334) 677-5642
Mailing address
4300 WEST MAIN STREET, STE 31, DOTHAN, AL 36305-4300
(334) 793-6511
(334) 677-5642
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
00006291
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000004270
—
AL
Enumeration date
05/03/2006
Last updated
11/05/2010
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