Cannon, D Timothy
Cannon, D Timothy is an individual health care provider with primary practice located at 971 Lakeland Dr Suite 1052, Jackson MS 39216-4643. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Cannon, D Timothy can be contacted via phone (601) 981-9503.Contact Information
Primary practice address
971 Lakeland Dr Suite 1052
Jackson MS 39216-4643
Phone: (601) 981-9503
Fax: (601) 981-7895
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 11015 | Mississippi |
Profile Details
| NPI number | 1033103122 |
|---|---|
| LBN Legal business name | Cannon, D Timothy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 6th, 2005 |
| Last updated | Oct 31st, 2011 - about 14 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 | 1033103122 | NPPES |
| Mississippi | MEDICAID | 00011216 |
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