Cannon, Philip John

Cannon, Philip John is an individual health care provider with primary practice located at 1000 Medical Center Blvd , Lawrenceville GA 30045-7694. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Cannon, Philip John can be contacted via phone (678) 442-3317.

Contact Information

Primary practice address
1000 Medical Center Blvd Lawrenceville GA 30045-7694
Phone: (678) 442-3317
Fax: (678) 442-4416
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 029853 Georgia

Profile Details

NPI number 1194852392
LBN Legal business name Cannon, Philip John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2007
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 1194852392 NPPES
Georgia MEDICAID 00361292E

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