Free National NPI Number Registry
John C Canon
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NPI Number Detailed Information
Provider Information:
| Name: | John C Canon |
| Gender: | M |
| Provider License Number If Given: | 27434 |
NPI Information:
| NPI: | 1699778639 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 5/23/2005 |
| Last Update Date: | 9/27/2010 |
Provider Business Mailing Address:
| Address: | PO BOX 344 Winston Salem, NC 27102 |
| Phone Number: | 3367162255 |
| Fax Number: | 3367165438 |
Provider Business Practice Location Address:
| Address: | 1370 W D ST North Wilkesboro, NC 28659 |
| Phone Number: | 3367162255 |
| Fax Number: | 3367165438 |
Provider Taxonomy:
| Primary: | 207P00000X |
| Secondary (if any): | 207Q00000X |
| State: | NC |
