Individual
WILLIAM J CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 MCMILLEN ST, FORT ATKINSON, WI 53538-1233
(920) 563-5571
Mailing address
PO BOX 249, FORT ATKINSON, WI 53538-0249
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
36081211
IL
207R00000X
Internal Medicine Physician
65437
WI
207R00000X
Internal Medicine Physician
Primary
65437-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36081211
—
IL
Enumeration date
02/14/2006
Last updated
10/07/2022
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