Individual
JOHN DAVID MCCANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
2022037578
MO
207W00000X
Ophthalmology Physician
2899121205
UT
2086S0122X
Plastic and Reconstructive Surgery Physician
2022037578
MO
2086S0122X
Plastic and Reconstructive Surgery Physician
2899121205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015005
ALTIUS
—
05
—
100506327
—
NV
01
—
1057048
CCN
—
01
—
107030566101
IHC SELECT HEALTH
UT
01
—
107030566101
IHC
—
05
—
114400600
—
WY
01
—
5069010
AETNA
—
01
—
521709
DMBA
—
05
—
805502900
—
ID
01
—
8806278
CIGNA
—
01
—
PAR TAX ID
GEHA
—
Enumeration date
05/03/2006
Last updated
04/12/2024
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