D Timothy Cannon is a Specialist in Jackson, Mississippi. D Timothy Cannon practices all healthcare services and medical treatments related to Specialist. The NPI Number for D Timothy Cannon is 1033103122. The last update date is 2011-10-31.
D Timothy Cannon's current location address is 971 Lakeland Dr, Jackson, Mississippi. You can contact this provider via phone number 6019819503 and fax number 6019817895. The mailing address for D Timothy Cannon is 971 Lakeland Dr, Jackson, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | D Timothy Cannon |
|---|---|
| Address | 971 Lakeland Dr, Jackson, Mississippi |
| Phone Number | 6019819503 |
| Fax Number | 6019817895 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1033103122 |
|---|---|
| Provider Enumeration Date | 2005-09-06 |
| Last Updated Date | 2011-10-31 |
Provider Mailing Address Detail
| Address | 971 Lakeland Dr |
|---|---|
| City | Jackson |
| State | Mississippi (MS) |
| Post Code | 392164643 |
| Phone Number | 6019819503 |
| Fax Number | 6019817895 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 11015 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 11216 | MS | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to D Timothy Cannon?
The D Timothy Cannon has been issued the NPI (National Provider Identifier) 1033103122 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete street address where D Timothy Cannon is physically located?
The D Timothy Cannon is physically situated at the following address: 971 Lakeland Dr, Jackson, MS, 392164643.
What is D Timothy Cannon's area of expertise and its corresponding taxonomy classification?
The D Timothy Cannon's field of specialization is Specialist, and it falls under the taxonomy code 174400000X, which categorizes healthcare providers based on their areas of practice.
On what date did the D Timothy Cannon receive the assignment of its 1033103122 from the Centers for Medicare & Medicaid Services?
The D Timothy Cannon was issued its 1033103122 by the Centers for Medicare & Medicaid Services on 2005-09-06.
When was the information regarding D Timothy Cannon most recently updated?
The details pertaining to the D Timothy Cannon, including its address, specialty, and other relevant information, were last refreshed on 2011-10-31.