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NPI Code Detail

MEDICARE: JOSH ROBERT MARRIS GANN

MEDICARE: JOSH ROBERT MARRIS GANN
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1598623860
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSH ROBERT MARRIS GANN
Provider Business Mailing Address
First Line : 2315 WOLFE DR NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-3757
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 800 S LEE HWY
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-5853
Country : US
Telephone Number : 423-506-8333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2026
Last Update Date : 01/14/2026

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Directions to “ JOSH ROBERT MARRIS GANN ” Practice Location

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