Doctor Name: | MR. G DWAYNE GANN |
NPI Number: | 1003831900 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | R,MR |
License Number: | 259436 |
Business Practice Address: | 1201 13th Ave Se Decatur, AL - 356014300 |
Business Phone Number: | 2563507779 |
Business Fax Number: | 2563502272 |
Mailing Address: | 1804 Woodall Rd Sw, DECATUR |
State: | AL |
Postal Code: | 356034314 |
Phone Number: | 2563060554 |
Fax Number: | |
NPI Enumeration Date: | 07/12/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 247100000X |
License Number: | 259436 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Radiologic Technologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |