Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 34078 | AL |
N | 204F00000X | Transplant Surgeon | 49884 | KY |
NPI | 1841462744 |
---|---|
Provider Name | Dr. Robert Martyn Cannon |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35249 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2008 |
Last Update Date | 05/04/2019 |