Individual
DR. GEORGE HALES CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
360 E 4500 S STE 4, SALT LAKE CITY, UT 84107-4297
(801) 266-0055
(801) 266-0056
Mailing address
PO BOX 30309, CHARLESTON, SC 29417-0309
(843) 284-3400
(843) 284-3401
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
164808-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87032604800106349
—
UT
Enumeration date
03/17/2006
Last updated
03/03/2008
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