Individual
DR. TIMOTHY L CANNON
Active
Individual
DR. TIMOTHY L CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101249711
VA
207RH0000X
Hematology (Internal Medicine) Physician
0101249711
VA
207RH0003X
Hematology & Oncology Physician
0101249711
VA
207RX0202X
Medical Oncology Physician
Primary
0101249711
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376719906
—
VA
01
—
VV8084A
MEDICARE PTAN
VA
Enumeration date
05/04/2008
Last updated
09/10/2021
Update your record
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