Individual
DR. PATRICK KEVIN CANON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3155 N UNION BLVD, COLORADO SPRINGS, CO 80907-8703
(719) 219-1312
(719) 635-3578
Mailing address
3155 N UNION BLVD, COLORADO SPRINGS, CO 80907-8703
(719) 219-1312
(719) 635-3578
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0427635
KS
207W00000X
Ophthalmology Physician
112821
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00162955
RAILROAD MEDICARE
—
Enumeration date
08/23/2005
Last updated
06/21/2011
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