Provider Demographics
NPI:1699729921
Name:CANNON, JAMES W (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:CANNON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:420 NORTH JAMES ROAD
Mailing Address - Street 2:MENTAL HEALTH 116
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219
Mailing Address - Country:US
Mailing Address - Phone:614-257-5200
Mailing Address - Fax:614-257-5418
Practice Address - Street 1:420 NORTH JAMES ROAD
Practice Address - Street 2:MENTAL HEALTH 116
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219
Practice Address - Country:US
Practice Address - Phone:614-257-5200
Practice Address - Fax:614-257-5418
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2011-12-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ285262084P0800X
OH35.0977612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry