Cannon, Charles Lawrence
Cannon, Charles Lawrence is an sole proprietor health care provider with primary practice located at 1218 W Willow Ste A, Enid OK 73703-2534. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Cannon, Charles Lawrence can be contacted via phone (580) 233-2176.Contact Information
Primary practice address
1218 W Willow Ste A
Enid OK 73703-2534
Phone: (580) 233-2176
Fax: (580) 233-2179
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 17275 | Oklahoma |
Profile Details
| NPI number | 1073519815 |
|---|---|
| LBN Legal business name | Cannon, Charles Lawrence |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 27th, 2005 |
| Last updated | Dec 11th, 2012 - about 13 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 | 1073519815 | NPPES |
| Georgia | Other | 100007598 | RAILROAD MEDICARE |
| Georgia | Other | 0000 | RAILROAD MEDICARE |
| Georgia | MEDICAID | 100088540A | RAILROAD MEDICARE |
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