Jackie B Cannon, DPT is a
Physical Therapist based in Dagsboro, Delaware. Jackie B Cannon is licensed to practice in Pennsylvania (license number PT003408L) and her current practice location is
35111 Seagrass Plantation Ln, Dagsboro, Delaware. She can be reached at her office (for appointments etc.) via phone at
(866) 484-8193.
NPI number for Jackie B Cannon is 1770628067 and her current mailing address is 35111 Seagrass Plantation Ln, Dagsboro, Delaware. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1770628067.
Healthcare Provider's Profile
Full Name | Jackie B Cannon |
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Gender | Female |
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Speciality | Physical Therapist |
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Location | 35111 Seagrass Plantation Ln, Dagsboro, Delaware |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1770628067
- Provider Enumeration Date: 02/21/2007
- Last Update Date: 02/25/2019
Medical Identifiers
Medical identifiers for Jackie B Cannon such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1770628067 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2251X0800X | Physical Therapist - Orthopedic | 6994 (South Carolina) | Secondary |
225100000X | Physical Therapist | PT003408L (Pennsylvania) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jackie B Cannon is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jackie B Cannon, DPT 35111 Seagrass Plantation Ln, Dagsboro, DE 19939-3391 Ph: (866) 484-8193 | Jackie B Cannon, DPT 35111 Seagrass Plantation Ln, Dagsboro, DE 19939 Ph: (866) 484-8193 |
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