Individual
DOUGLAS TODD CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8000 CENTERVIEW PKWY, SUITE 500, CORDOVA, TN 38018-4227
(901) 759-3100
(901) 759-3196
Mailing address
1400 S GERMANTOWN RD, GERMANTOWN, TN 38138-2205
(901) 759-3100
(901) 759-3196
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
50010
TN
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
22876
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05254852
—
MS
05
—
100295624
—
MS
05
—
199076001
—
AR
05
—
Q004010
—
TN
Enumeration date
07/14/2006
Last updated
02/16/2023
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