Individual
DR. JAYSON D CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
76 TABB DR, SUITE C, MUNFORD, TN 38058-8611
(901) 840-2234
(901) 840-2237
Mailing address
PO BOX 668, ATOKA, TN 38004
(901) 840-2234
(901) 840-2237
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
DC00000001905
TN
111N00000X
Chiropractor
Primary
DC0000001905
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4166378
BLUE CROSS BLUE SHIELD OF TENNESSEE
TN
Enumeration date
07/07/2005
Last updated
05/25/2011
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