Individual
DOMENIC MICHAEL CANONICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
507 NW ATLANTIC ST, TULLAHOMA, TN 37388-3504
(931) 393-4332
(931) 393-2304
Mailing address
507 NW ATLANTIC ST, TULLAHOMA, TN 37388-3504
(931) 393-4332
(931) 393-2304
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
18819
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0192943
BCBS
TN
01
—
040013804
RAILROAD MEDICARE
TN
05
—
3085592
—
TN
Enumeration date
03/08/2006
Last updated
07/14/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us