Individual
DR. JULIA H GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1201 11TH AVE S, SUITE 501, BIRMINGHAM, AL 35205-3423
(205) 930-0930
(205) 930-9050
Mailing address
1201 11TH AVE S, SUITE 501, BIRMINGHAM, AL 35205-3423
(205) 930-0930
(205) 930-9050
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S708TA316
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51502838
BCBS
AL
05
—
528500580
—
AL
Enumeration date
09/21/2005
Last updated
10/18/2017
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