National Provider Identifier Database

PAUL CANNON, PA – NPI #1790212629
Surgical


Contact Information

PAUL CANNON, PA
395 W COUGAR BLVD STE 503
PROVO, UT84604-3323
Phone: 801-442-3936
Fax:
Website:
Specialty Taxonomy Code
* Surgical 363AS0400X
Medical 363AM0700X

* Indicates primary specialty

NPI Profile & details for PAUL CANNON

NPI Number 1790212629
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 05/23/2017
Last updated 08/16/2022 - About 4 years ago
Sole proprietor1 No
Identifiers
  • CO License #: PA.0005119
  • UT License #: 12917809-1206
Hospital affiliation n/a

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.

Reviews for PAUL CANNON, PA

There are currently no reviews for PAUL CANNON, PA


NPIdb - Home
v2.201