Organization
CANNON PLASTIC & RECONSTRUCTIVE SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLIFTON L CANNON III MD (PRESIDENT)
(912) 354-7044
Entity
Organization
Contact information
Practice address
5205 FREDERICK ST, SAVANNAH, GA 31405-4501
(912) 354-7044
(912) 355-3066
Mailing address
PO BOX 15878, SAVANNAH, GA 31416-2578
(912) 354-7044
(912) 355-3066
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
06/29/2012
Last updated
11/19/2012
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