Cannon, Bruce W

Cannon, Bruce W is an individual health care provider with primary practice located at 1710 Harper Rd , Beckley WV 25801-3357. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Cannon, Bruce W can be contacted via phone (800) 277-8151.

Contact Information

Primary practice address
1710 Harper Rd Beckley WV 25801-3357
Phone: (800) 277-8151
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 1540 West Virginia
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 1540 West Virginia

Profile Details

NPI number 1861487217
LBN Legal business name Cannon, Bruce W
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2005
Last updated Jul 8th, 2007 - about 17 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 1861487217 NPPES
West Virginia MEDICAID 0061930000

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