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Individual

MR. Z'THOMAS KIRK CANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT

Contact information

Practice address
SYDNEY & LAMONT ST, JAMES H QUILLEN VA MEDIACL CENTER, MT. HOME, TN 37684
(423) 926-1171
Mailing address
119 MEADOWSTONE DR, UNICOI, TN 37692-6623
(423) 743-5012

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA0000000734
TN

Other

Enumeration date
07/03/2006
Last updated
07/08/2007
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