Individual
STEPHEN R CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1325 WRIGHT AVE STE A, CROWLEY, LA 70526-2226
(337) 783-4043
(337) 783-4053
Mailing address
1325 WRIGHT AVE STE A, CROWLEY, LA 70526-2226
(337) 783-4043
(337) 783-4053
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
025690
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1048577
—
LA
05
—
2372793
—
LA
Enumeration date
12/19/2006
Last updated
07/29/2020
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