Cannon, David
Cannon, David is an individual health care provider with primary practice located at 3200 S Airport Rd W #146, Traverse City MI 49684-8117. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Cannon, David can be contacted via phone (231) 941-5440.Contact Information
Primary practice address
3200 S Airport Rd W #146
Traverse City MI 49684-8117
Phone: (231) 941-5440
Fax: (231) 941-0893
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | DC00295 | Michigan |
Profile Details
| NPI number | 1487630133 |
|---|---|
| LBN Legal business name | Cannon, David |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 15th, 2005 |
| Last updated | Jul 29th, 2011 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487630133 | NPPES |
| Michigan | MEDICAID | 3278492 |
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