PICKENS A. GANTT M.D. NPI 1063519445

NPI Information

NPI: 1063519445
Provider Name: PICKENS A. GANTT, M.D.
Classification: Obstetrics & Gynecology - 207VE0102X
Entity Type: Individual

Specialization: Reproductive Endocrinology

Address:
830 PENNSYLVANIA AVE
SUITE 205
CHARLESTON, WV
ZIP 25302
Phone: (304) 388-2863
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Pickens A. Gantt, M.D. is a reproductive endocrinology obstetrics gynecology in Charleston, WV. The provider is an obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility. Pickens A. Gantt, M.D. NPI is 1063519445. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

830 PENNSYLVANIA AVE
SUITE 205
CHARLESTON, WV
ZIP 25302-302
Phone: (304) 388-2863
Fax: (304) 388-2866

The enumeration date for this NPI number is 9/20/2006 and was last updated on 12/14/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		13100	TENNESSEE	No
2	207VE0102X	Obstetrics & Gynecology	Reproductive Endocrinology	22945	WEST VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3810010685	MEDICAID	WEST VIRGINIA
2	GN4224353	MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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