Individual
JOHN C CANON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1370 W D ST, NORTH WILKESBORO, NC 28659-3506
(336) 716-2255
(336) 716-5438
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-5438
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
27434
NC
207Q00000X
Family Medicine Physician
27434
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8921057
—
NC
Enumeration date
05/23/2005
Last updated
09/27/2010
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