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Individual

DR. BRIAN SCOTT GANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
850 PETER BRYCE BLVD, TUSCALOOSA, AL 35401-7419
(205) 348-1304
(205) 348-7988
Mailing address
850 PETER BRYCE BLVD, TUSCALOOSA, AL 35401-7419
(205) 348-1304
(205) 348-7988

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
32891
AL
208000000X
Pediatrics Physician
40582
KY
208000000X
Pediatrics Physician
MD30442
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3830971
TN
05
64122582
KY
Enumeration date
09/19/2005
Last updated
07/21/2022
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