Cannon, William J

Cannon, William J is an individual health care provider with primary practice located at 500 Mcmillen St , Fort Atkinson WI 53538-1233. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Cannon, William J can be contacted via phone (920) 563-5571.

Contact Information

Primary practice address
500 Mcmillen St Fort Atkinson WI 53538-1233
Phone: (920) 563-5571
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 36081211 Illinois
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 65437 Wisconsin
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 65437-20 Wisconsin

Profile Details

NPI number 1912971243
LBN Legal business name Cannon, William J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2006
Last updated Oct 7th, 2022 - 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 1912971243 NPPES
Illinois MEDICAID 36081211

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