Individual
DR. GRANT WILSON CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
VAMC (11E), 500 FOOTHILL BOULEVARD, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
(801) 584-1277
Mailing address
VAMC (11E), 500 FOOTHILL BOULEVARD, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
(801) 584-1277
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
165454-1205
UT
Other
Enumeration date
06/30/2006
Last updated
07/09/2007
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