Individual
DEREK SLOANE CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1530 US HIGHWAY 43, WINFIELD, AL 35594-5056
(205) 487-7000
(877) 915-6502
Mailing address
12370 ROAD 505, PHILADELPHIA, MS 39350-3364
(601) 504-3170
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
30358
AL
208600000X
Surgery Physician
Primary
22691
MS
282N00000X
General Acute Care Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07877038
—
MS
Enumeration date
10/22/2007
Last updated
01/03/2022
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