Cannon, Michael

Cannon, Michael is an sole proprietor health care provider with primary practice located at 402 E Zavala St , Crystal City TX 78839-3337. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Cannon, Michael can be contacted via phone (720) 252-7546.

Contact Information

Primary practice address
402 E Zavala St Crystal City TX 78839-3337
Phone: (720) 252-7546
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 2169 Texas
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 2169 Texas

Profile Details

NPI number 1922494673
LBN Legal business name Cannon, Michael
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 9th, 2015
Last updated Apr 11th, 2021 - about 3 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 1922494673 NPPES
Texas MEDICAID 3520348-01

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