Individual
DR. JOHN CONCANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1145 RESERVOIR AVE, SUITE 124, CRANSTON, RI 02920-6055
(401) 943-7337
(401) 942-1509
Mailing address
1145 RESERVOIR AVE, SUITE 124, CRANSTON, RI 02920-6055
(401) 943-7337
(401) 942-1509
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
DO-00357
RI
Other
Enumeration date
07/02/2005
Last updated
07/08/2007
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