Healthcare Provider Details

I. General information

NPI: 1780776286
Provider Name (Legal Business Name): WILLIAM CHRISTOPHER GANNAWAY M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 GOSS RD SW FOX ARMY HEALTH CLINIC
HUNTSVILLE AL
35809-0001
US

IV. Provider business mailing address

4100 GOSS RD SW FOX ARMY HEALTH CLINIC
HUNTSVILLE AL
35809-0001
US

V. Phone/Fax

Practice location:
  • Phone: 256-955-8888
  • Fax: 256-876-3333
Mailing address:
  • Phone: 256-955-8888
  • Fax: 256-876-3333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number00024964
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: