Cannon, Brian Wayne

Cannon, Brian Wayne is an individual health care provider with primary practice located at 8810A Farrow Rd , Columbia SC 29203-8802. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Cannon, Brian Wayne can be contacted via phone (803) 741-2010.

Contact Information

Primary practice address
8810A Farrow Rd Columbia SC 29203-8802
Phone: (803) 741-2010
Fax: (803) 741-2011
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 970 South Carolina

Profile Details

NPI number 1164494423
LBN Legal business name Cannon, Brian Wayne
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2006
Last updated Nov 4th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1164494423 NPPES
South Carolina MEDICAID D09701

Popular Providers