Individual
DR. MAX KENT CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
39 PROFESSIONAL WAY, SUITE 2, PAYSON, UT 84651-1675
(801) 465-1701
(801) 465-1707
Mailing address
PO BOX 508, PAYSON, UT 84651-0508
(801) 465-1701
(801) 465-1707
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
97-347-228-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101271
IHC-UT/ALL USA
UT
Enumeration date
08/04/2006
Last updated
07/08/2007
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