Individual
LIAM G. GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100A MACDONOUGH DR, VERGENNES, VT 05491-1057
(802) 877-0157
Mailing address
100A MACDONOUGH DR, VERGENNES, VT 05491-1057
(802) 877-0157
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
0420010022
VT
207Q00000X
Family Medicine Physician
Primary
042-0010022
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN2298
—
VT
05
—
OVN2298
—
VT
Enumeration date
04/17/2006
Last updated
04/16/2024
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