Organization
JOE RONALD CANNON
Active
Other names
Abilene Dermatopathology Lab
Organization subpart
No
Provider details
NPI number
Authorized official
JOE R CANNON MD (DERMATOPATHOLOGIST)
(325) 672-2162
Entity
Organization
Contact information
Practice address
802 ORANGE ST, ABILENE, TX 79601-4020
(325) 672-2162
Mailing address
PO BOX 3611, ABILENE, TX 79604-3611
(325) 672-2162
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
E2498
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025322101
—
TX
01
—
CL0449
BLUE CROSS
TX
Enumeration date
03/15/2007
Last updated
01/08/2010
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