Organization
GANNON MEDICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLEY GANNON (MANAGER)
(225) 718-3764
Entity
Organization
Contact information
Practice address
607 RUE DE BRILLE, NEW IBERIA, LA 70563-2169
(337) 367-1247
(337) 365-7496
Mailing address
124 KAROLWOOD DR, LAFAYETTE, LA 70503-3505
(225) 718-3764
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
05/13/2021
Last updated
05/21/2021
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