Organization
THOMAS S CANNON MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS S. CANNON M.D. (PRES/SOLE OWNER)
(480) 507-2961
Entity
Organization
Contact information
Practice address
3580 W 9000 S, WEST JORDAN, UT 84088-8812
(801) 561-8888
Mailing address
PO BOX 1847, GILBERT, AZ 85299-1847
(480) 507-2961
(480) 507-2971
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
377750-1205/8905
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740445576
—
UT
Enumeration date
07/21/2008
Last updated
03/07/2023
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