Individual
FAY ALEXANDER CANNON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8002 KING HELIE BLVD, NEW PORT RICHEY, FL 34653-1435
(727) 841-4430
Mailing address
PO BOX 428, NEW PORT RICHEY, FL 34656-0428
(727) 841-4200
(727) 841-4365
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME95147
FL
Other
Enumeration date
08/13/2006
Last updated
07/08/2007
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