Cannon, Heather

Cannon, Heather is an individual health care provider with primary practice located at 1122 E Main St Suite 4, Philadelphia MS 39350-2348. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Cannon, Heather can be contacted via phone (601) 656-1001.

Contact Information

Primary practice address
1122 E Main St Suite 4 Philadelphia MS 39350-2348
Phone: (601) 656-1001
Fax: (601) 656-7555
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 22698 Mississippi
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 29398 Alabama

Profile Details

NPI number 1801082409
LBN Legal business name Cannon, Heather
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 18th, 2007
Last updated Jul 21st, 2015 - about 9 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 1801082409 NPPES
Mississippi MEDICAID 03123057

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