Cannon, Timothy L
Cannon, Timothy L is an individual health care provider with primary practice located at 8081 Innovation Park Dr , Fairfax VA 22031-4867. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hematology, Allopathic & Osteopathic Physicians / Hematology & Oncology, Allopathic & Osteopathic Physicians / Medical Oncology. Allopathic & Osteopathic Physicians / Medical Oncology is his primary health care specialty. Cannon, Timothy L can be contacted via phone (571) 472-4724.Contact Information
Primary practice address
8081 Innovation Park Dr
Fairfax VA 22031-4867
Phone: (571) 472-4724
Fax: (571) 472-0241
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 0101249711 | Virginia |
| Allopathic & Osteopathic Physicians / Hematology | 207RH0000X | 0101249711 | Virginia |
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | 0101249711 | Virginia |
| Allopathic & Osteopathic Physicians / Medical Oncology | 207RX0202X | 0101249711 | Virginia |
Profile Details
| NPI number | 1376719906 |
|---|---|
| LBN Legal business name | Cannon, Timothy L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 4th, 2008 |
| Last updated | Sep 10th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376719906 | NPPES |
| Virginia | MEDICAID | 1376719906 | |
| Virginia | Other | VV8084A |
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