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Contact Information

NATHAN A CANNON, M.D./PH.D.
11050 PARKVIEW CIRCLE DR
FORT WAYNE, IN46845
 Phone: 260-266-9100
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Radiation Oncology

2085R0001X 92 Physician/Radiation Oncology
Indicates primary specialty

NPI Profile & details for NATHAN A CANNON · (Male)

NPI Number 1225343072
Status Active
Credentials M.D./PH.D.
Entity Individual
Enumeration date 08/17/2010
Last updated 06/15/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01075113A
  • IN Medicaid 201292540
  • OH Medicaid 0134869
Hospital affiliation(s)
  • CAMERON MEMORIAL COMMUNITY HOSPITAL INC - (Critical Access)
    416 E MAUMEE ST
    ANGOLA, IN 46703
  • PARKVIEW REGIONAL MEDICAL CENTER - (Acute Care)
    11109 PARKVIEW PLAZA DRIVE
    FORT WAYNE, IN 46845
  • WABASH COUNTY HOSPITAL - (Critical Access)
    710 N EAST ST
    WABASH, IN 46992
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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