Individual provider · Type 1 NPI

Gannon Tissot, PA

Physician Assistant · Columbia, TN

NPI number 1417813692 Active

Practice location

1050 N James M Campbell Blvd Ste 200
Columbia, TN 38401-2754

Mailing address

PO Box 160909
Altamonte Springs, FL 32716-0909

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XNone listed

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1417813692

Gannon Tissot, PA's National Provider Identifier is 1417813692, issued on Dec 31, 2025. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Columbia, TN. The record was last updated on Oct 28, 2026.