D Timothy Cannon M.D.

NPI 1033103122 - Specialist - 174400000X

NPI Details
NPI 1033103122
Gender Male
Enumeration Date 09/06/2005
Last Updated 10/31/2011
Entity Type Individual
Active Over 11 years ago
Practice Location
971 LAKELAND DR
SUITE 1052
JACKSON MS, 39216-4643, US
Phone (601) 981-9503
Fax (601) 981-7895
Business Location
971 LAKELAND DR
SUITE 1052
JACKSON MS, 39216-4643, US
Phone (601) 981-9503
Fax (601) 981-7895
Toxanomy
Taxonomy Code 174400000X
License State Mississippi
License Number 11015
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According to our database, D Timothy Cannon M.D. NPI is 1033103122, taxonomy code is 174400000X and license number is 11015, license state is located at Mississippi. D Timothy Cannon M.D. physically located at 971 Lakeland Dr, Jackson MS, 39216-4643. NPI Number D Timothy Cannon M.D. has the Individual type.

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1033103122 NPI number is provided on an as is basis without warranty of any kind. 1033103122 is maintained by the National Plan & Provider Enumeration System. The contents of D Timothy Cannon M.D. are for informational purposes only.