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DR. ROBERT A. GANNAWAY M.D.

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1649227745

Individual Registrant:
DR. ROBERT A. GANNAWAY M.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
408 E RAILROAD AVE SUITE B CRYSTAL SPRINGS, MS 39059-2520 US
Tel: 601-892-7860  Fax: 601-892-7861

Contact information for business:
408 E RAILROAD AVE SUITE B CRYSTAL SPRINGS, MS 39059-2520 US
Tel: 601-892-7860  Fax: 601-892-7861

Registration Information:
NPI: 1649227745
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
MS12331

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
01529794MS05
TIN20194435401




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