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Contact Information

MICHAEL L CANNON
5206 WALNUT CT
LITHONIA, GA30038-4873
 Phone: 678-481-7808
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for MICHAEL L CANNON · (Male)

NPI Number 1861952251
Status Active
Credentials
Entity Individual
Enumeration date 03/21/2019
Last updated 03/21/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • GA License # 0578
Hospital affiliation(s) Not Available
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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