Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TIM B GANNON, P.A.
ActiveTIM B GANNON, P.A. is a Medical Physician Assistant healthcare provider located in SANTA FE, New Mexico. NPI 1780992024 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · SANTA FE, NM
Registration Details
- NPI Number
- 1780992024
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 21, 2010 (15.896684956698 yrs)
- Last Updated
- Oct 8, 2013
- License
-
PA2010-0058 (NM)
Practice Information
- Address
-
3450 ZAFARANO DRSUITE CSANTA FE, NM, 875072669Browse NM providers · Browse ZIP 87507
- Phone
- 5054665885
- Fax
- 5054665886
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Other Medical Physician Assistant Providers in SANTA FE, NM
| Name | Credential | NPI |
|---|---|---|
| WILLIAM T BACON IV | PA-C | 1730181942 |
| MS. BRIDGET CORNELL ANDREW | PA,MPH | 1649279266 |
| MS. PATRICIA E MCCULLOCH | PA-C | 1780676866 |
| MR. MILTON ALLEN MATTESON | PA-C | 1811980279 |
| RAYMOND C GALLEY | PA-C | 1316935323 |
| MS. LYNN A DEVLIN | PA | 1811965254 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.