Individual
DR. CHARLES RON CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1038 RIVER OAKS DR, FLOWOOD, MS 39232
(601) 932-5244
(601) 939-0545
Mailing address
PO BOX 5345, JACKSON, MS 39296
(601) 932-5244
(601) 939-0545
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
07635
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08553384
—
MS
Enumeration date
08/30/2006
Last updated
04/24/2013
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