Cannon, Scott Lawrence

Cannon, Scott Lawrence is an individual health care provider with primary practice located at 1650 Cowles St , Fairbanks AK 99701-5925. He recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Specialist/Technologist, Pathology, which is considered as his primary health care specialty. Cannon, Scott Lawrence can be contacted via phone (907) 458-5650.

Contact Information

Primary practice address
1650 Cowles St Fairbanks AK 99701-5925
Phone: (907) 458-5650
Fax: (907) 456-8050
Website:
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Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Specialist/Technologist, Pathology 246Q00000X 3351 Alaska

Profile Details

NPI number 1164472742
LBN Legal business name Cannon, Scott Lawrence
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Dec 9th, 2010 - about 16 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 1164472742 NPPES
Alaska MEDICAID MD3351
Alaska Other 220030113

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