Organization
CANNON PLASTIC & RECONSTRUCTIVE SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLIFTON LAMAR CANNON III MD (OWNER)
(912) 547-1091
Entity
Organization
Contact information
Practice address
4750 WATERS AVE, SUITE 512, SAVANNAH, GA 31404-6200
(912) 547-1091
Mailing address
4750 WATERS AVE, SUITE 512, SAVANNAH, GA 31404-6200
(912) 547-1091
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
12/05/2011
Last updated
12/05/2011
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