Individual
CHRISTOPHER B CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 MARY STREET, EVANSVILLE, IN 47747-0001
(812) 450-3405
(812) 450-3099
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 450-6815
(812) 450-6822
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01058850A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000329531
BCBS PIN
IN
05
—
64078918
—
KY
01
—
P00152042
RR MCARE PIN
IN
Enumeration date
07/14/2006
Last updated
07/09/2007
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