Individual
GARY FANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1 HURLEY PLZ, FLINT, MI 48503-5902
(810) 262-9683
(810) 760-0440
Mailing address
1 HURLEY PLZ, FLINT, MI 48503-5902
(810) 262-9683
(810) 760-0440
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
06/12/2012
Last updated
06/12/2012
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