Individual
DR. JOHN SHRADER CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1661 AARON BRENNER DR STE 105, MEMPHIS, TN 38120-1467
(901) 756-8475
(901) 756-7820
Mailing address
1661 AARON BRENNER DR STE 105, MEMPHIS, TN 38120-1467
(901) 756-8475
(901) 756-7820
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS2752
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000516
ASSURANT #
TN
01
—
113786
CIGNA #
TN
01
—
2038634
AETNA #
TN
01
—
4079273
BLUE CROSS BLUE SHIELD
TN
01
—
532822
UNITED CONCORDIA #
TN
01
—
606051
COMPBENEFITS #
TN
Enumeration date
08/21/2006
Last updated
09/02/2009
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