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Individual

DR. ROBERT MINNICK CANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
700 SUNSET DR, SUITE 503, ATHENS, GA 30606-2288
(706) 613-1040
(706) 613-9120
Mailing address
700 SUNSET DR, SUITE 503, ATHENS, GA 30606-2288
(706) 613-1040
(706) 613-9120

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
33046
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00426544A
GA
Enumeration date
07/10/2006
Last updated
11/01/2011
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