Individual
DR. BRUCE W CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1710 HARPER RD, BECKLEY, WV 25801-3357
(800) 277-8151
Mailing address
L 2772, COLUMBUS, OH 43260-0001
(800) 277-8151
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
1540
WV
208VP0000X
Pain Medicine Physician
Primary
1540
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0061930000
—
WV
Enumeration date
09/13/2005
Last updated
09/11/2025
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