| David G Fanney, Do Pa | |
|
4241 Nw American Ln Lake City FL 32055-4881 | |
| (386) 752-2246 | |
| (386) 758-7998 |
| Full Name | David G Fanney, Do Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 4241 Nw American Ln, Lake City, Florida |
| Authorized Official Name and Position | David Grafton Fanney (PRISIDENT) |
| Authorized Official Contact | 3867522246 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David G Fanney, Do Pa 4241 Nw American Ln Lake City FL 32055-4881 Ph: (386) 752-2246 | David G Fanney, Do Pa 4241 Nw American Ln Lake City FL 32055-4881 Ph: (386) 752-2246 |
| NPI Number | 1891075032 |
|---|---|
| Provider Enumeration Date | 08/19/2011 |
| Last Update Date | 01/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891075032 | NPI | - | NPPES |
| 051724100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS0005960 (Florida) | Primary |
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