Cannon, Wayne M
Cannon, Wayne M 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, Wayne M 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:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 442 | South Carolina |
Profile Details
| NPI number | 1801861836 |
|---|---|
| LBN Legal business name | Cannon, Wayne M |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 22nd, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801861836 | NPPES |
| South Carolina | MEDICAID | D04424 |
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