Individual
DR. DARREN PAUL GANNUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
380 WOODS COVE RD, SCOTTSBORO, AL 35768-2428
(256) 505-6826
(256) 571-2862
Mailing address
6805 GREENHILL BLVD NW, FORT PAYNE, AL 35967-8325
(256) 505-6826
(256) 571-2862
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
44303
AL
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
2063
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009938031
—
AL
01
—
15-09393
UNITED BEHAVIORAL HEALTH
AL
01
—
15-19393
UNITED BEHAVIORAL HEALTH
AL
05
—
331300551
—
AL
05
—
331334651
—
AL
01
—
51536196
BLUE CROSS BLUE SHIELD
AL
Enumeration date
07/01/2006
Last updated
01/09/2025
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