Individual
BARRY GANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
75 HIGHWAY 62 412 STE J, ASH FLAT, AR 72513-9629
(870) 994-7060
(870) 996-7063
Mailing address
1815 PLEASANT GROVE RD, JONESBORO, AR 72401-7870
(870) 933-6886
(870) 933-9395
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
AR
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195507795
—
AR
Enumeration date
02/07/2013
Last updated
05/15/2018
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