| Cannon Family Medicine Llc | |
|
719 N Eastern Ave Crowley LA 70526-3856 | |
| (337) 783-5900 | |
| (337) 783-5914 |
| Full Name | Cannon Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 719 N Eastern Ave, Crowley, Louisiana |
| Authorized Official Name and Position | Stephen R Cannon (OWNER) |
| Authorized Official Contact | 3377835900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cannon Family Medicine Llc 719 N Eastern Ave Crowley LA 70526-3856 Ph: (337) 783-5900 | Cannon Family Medicine Llc 719 N Eastern Ave Crowley LA 70526-3856 Ph: (337) 783-5900 |
| NPI Number | 1043372089 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 03/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043372089 | NPI | - | NPPES |
| 1048577 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 025690 (Louisiana) | Primary |
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