| Robert A. Gannaway, M.d., Pllc | |
|
408 E Railroad Ave Suite B Crystal Springs MS 39059-2520 | |
| (601) 892-7860 | |
| (601) 892-7861 |
| Full Name | Robert A. Gannaway, M.d., Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 408 E Railroad Ave, Crystal Springs, Mississippi |
| Authorized Official Name and Position | Robert A. Gannaway (PHYSICIAN) |
| Authorized Official Contact | 6018927860 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert A. Gannaway, M.d., Pllc 408 E Railroad Ave Suite B Crystal Springs MS 39059-2520 Ph: (601) 892-7860 | Robert A. Gannaway, M.d., Pllc 408 E Railroad Ave Suite B Crystal Springs MS 39059-2520 Ph: (601) 892-7860 |
| NPI Number | 1942234117 |
|---|---|
| Provider Enumeration Date | 07/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942234117 | NPI | - | NPPES |
| 01529794 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 12331 (Mississippi) | Primary |
Family Medical Clinic Of Crystal Springs Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 104 W Railroad Ave S, Crystal Springs, MS 39059 Phone: 601-892-3063 Fax: 601-892-3570 | |
Crystal Springs Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 123 Bo Bo Dr, Crystal Springs, MS 39059 Phone: 601-892-1456 Fax: 601-892-1456 |