MEDICARE: DR. DAVID P GANNON JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	50303	MA
2	208VP0014X	Interventional Pain Medicine Physician	50303	MA
3	207L00000X	Anesthesiology Physician	50303	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AA124352	OTHER	MA	HARVARD PILGRIM HEALTH CARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518966472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID P GANNON JR. MD

Provider Business Mailing Address
First Line	:	68 N MAIN ST STE A125
Second Line	:
City	:	CARVER
State	:	MA
Zip	:	02330-1128
Country	:	US
Telephone Number	:	508-747-7246
Fax Number	:

Provider Business Practice Location Address
First Line	:	68 N MAIN ST
Second Line	:
City	:	CARVER
State	:	MA
Zip	:	02330-1128
Country	:	US
Telephone Number	:	508-747-7246
Fax Number	:	508-747-7256

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	04/24/2024

Similar Medicare Providers

1003893900 — DR. FREDERICK VINCENT JOHNSON PSY.D.
Practice Location Address:

68 N MAIN ST
CARVER, MA
02330-1128

Practice Phone: 508-866-5000
Practice Fax:

1447203500 — JORDAN HOSPITAL ANESTHESIA ASSOCIATES, PC
Practice Location Address:

68 N MAIN ST
CARVER, MA
02330-1128

Practice Phone: 508-747-7246
Practice Fax: 508-747-7256

1508005448 — CRANBERRY DENTAL ASSOCIATES, INC.
Practice Location Address:

70 N MAIN ST
CARVER, MA
02330-1128

Practice Phone: 508-866-3800
Practice Fax: 508-866-3811

1871736389 — FRANK W WETHERBEE JR. DMD
Practice Location Address:

70 N MAIN ST
CARVER, MA
02330-1128

Practice Phone: 508-866-3800
Practice Fax:

1952547994 — MRS. SARAH ELIZABETH BETTERS M.S.W. LICSW
Practice Location Address:

1 WHITE ROCK PATH
CARVER, MA
02330-1266

Practice Phone: 508-474-9256
Practice Fax:

1073566410 — CAPE COD PAIN MANAGEMENT, PC
Practice Location Address:

68 N MAIN ST
CARVER, MA
02330

Practice Phone: 508-747-7246
Practice Fax: 508-747-7256

Directions to “ DR. DAVID P GANNON JR. MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.