Provider Demographics
NPI:1427846831
Name:CANNON, ROBERT B JR
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:CANNON
Suffix:JR
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 N CAUSEWAY BLVD STE 501
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-3697
Mailing Address - Country:US
Mailing Address - Phone:504-309-0259
Mailing Address - Fax:
Practice Address - Street 1:3525 N CAUSEWAY BLVD STE 501
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3697
Practice Address - Country:US
Practice Address - Phone:504-309-0259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-26
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator