Individual
DR. BRETT H CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8954 HOSPITAL DR, DOUGLASVILLE, GA 30134-2272
(770) 920-6420
Mailing address
5665 NEW NORTHSIDE DR NW, SUITE 320, ATLANTA, GA 30328-5831
(770) 874-5400
(770) 874-5469
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101236067
VA
207P00000X
Emergency Medicine Physician
Primary
046053
GA
207P00000X
Emergency Medicine Physician
15230R
LA
207P00000X
Emergency Medicine Physician
200301097
NC
207P00000X
Emergency Medicine Physician
MD.25283
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00866115I
—
GA
05
—
00866115J
—
GA
05
—
00866115K
—
GA
05
—
00866115L
—
GA
01
—
051542477
BCBS
AL
05
—
051559698
—
AL
01
—
7559160
AETNA
AL
Enumeration date
08/17/2006
Last updated
12/04/2007
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