Cannon, Charles D

Cannon, Charles D is an individual health care provider with primary practice located at 1203 Jefferson St , Laurel MS 39440-4354. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Cannon, Charles D can be contacted via phone (601) 649-2863.

Contact Information

Primary practice address
1203 Jefferson St Laurel MS 39440-4354
Phone: (601) 649-2863
Fax: (601) 649-9479
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 09089 Mississippi

Profile Details

NPI number 1841214145
LBN Legal business name Cannon, Charles D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2006
Last updated Jul 11th, 2013 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841214145 NPPES
Mississippi MEDICAID 00014391

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