DEREK SLOANE CANNON (NPI# 1902095466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902095466 |
| Entity Type | Individual |
| Full Name | DEREK SLOANE CANNON |
| Credential | M.D. |
| Practice Address |
1003 Holland Ave Suite 101 Philadelphia MS 39350-2180 |
| Mailing Address |
12370 Road 505 Philadelphia MS 39350-3364 |
| Practice Telephone | 6017812395 |
| Practice Fax Number | 6017812396 |
| Mailing Telephone | 6015043170 |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2015-11-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 30358 | AL | Allopathic & Osteopathic Physicians |
| Y | 208600000X | Surgery | 22691 | MS | Allopathic & Osteopathic Physicians |
| N | 282N00000X | General Acute Care Hospital | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 07877038 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457750614 | Derek Cannon | Pharmacist | 1114 E Main St, Brownsville, TN 38012-2621 | 2014-08-13 |
| Street Address |
1003 HOLLAND AVE SUITE 101 |
| City | PHILADELPHIA |
| State | MS |
| Zip Code | 39350-2180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871538652 | Andrew Pace Dabbs | Surgery | 1003 Holland Ave, Suite 101, Philadelphia, MS 39350-2161 | 2006-06-17 |
| 1144665670 | Neshoba County General Hospital | Family Medicine | 1003 Holland Ave, Suite 103, Philadelphia, MS 39350-2180 | 2013-05-10 |
| 1033346044 | Neshoba Urgent Care Clinic | Family Medicine | 1003 Holland Ave, Suite 102, Philadelphia, MS 39350-2180 | 2009-06-17 |
| 1013142017 | Neshoba Foot and Ankle Clinic | Podiatrist | 1003 Holland Ave, Suite 102, Philadelphia, MS 39350-2180 | 2009-05-19 |
| 1861578536 | Surgery Clinic of Philadelphia | General Practice | 1003 Holland Ave, Suite 101, Philadelphia, MS 39350-2180 | 2006-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548817133 | Airpark Family Dentistry | Dentist | 1060 Holland Avenue, Philadelphia, MS 39350 | 2019-08-20 |
| 1396303962 | Medical Foundation Inc | Obstetrics & Gynecology | Rush Medical Group / Philadelphia, 1106 Central Drive, Ste 3, Philadelphia, MS 39350 | 2019-05-30 |
| 1144759580 | Mapp Home Care Services | In Home Supportive Care | 41 Eastover Dr, Philadelphia, MS 39350 | 2017-06-08 |
| 1710411707 | Rcg Mississippi, Inc. | Clinic/Center | 1100 Central Drive, Philadelphia, MS 39350 | 2017-04-17 |
| 1114339405 | Bernard Oneal | Adult Companion | 10090 Rd 0022, None, Philadelphia, MS 39350 | 2014-05-21 |
| 1417213323 | Region Ten Commision On Mental Health | Clinic/Center | 1011 Posey Avenue, Philadelphia, MS 39350 | 2012-04-04 |
| 1851427132 | Performance Therapy LLC | Physical Therapist | Performance Therapy, LLC, 921 W Beacon Street, Philadelphia, MS 39350 | 2007-02-23 |
| 1922161900 | Ernest Barton Cross | Audiologist | 1120 East Main Street, Suite 4, Philadelphia, MS 39350 | 2006-12-19 |
| 1649348129 | Augustus P Soriano | Family Medicine | 517 Center Avenue, Philadelphia, MS 39350 | 2006-12-01 |
| 1982777983 | Bill G Molpus | Dentist | 247 Byrd Ave, Philadelphia, MS 39350 | 2006-11-16 |
| Find all providers in zip 39350 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1962993170 | Brian M Till | Surgery | 1015 Walnut Street, Suite 620 Curtis, Philadelphia, PA 19107-5005 | 2018-05-23 |
| 1356838932 | Walker Lyons | Surgery | 1015 Walnut St Ste 210, Philadelphia, PA 19107-5005 | 2018-04-18 |
| 1790213114 | Matthew Paul Mullarkey | Surgery | 3401 N Broad St Ste C405, Philadelphia, PA 19140-5103 | 2017-05-30 |
| 1528424090 | Zhen Lu | Surgery | 5401 Old York Rd # Klein101, Philadelphia, PA 19141-3030 | 2016-01-13 |
| 1235517996 | David Kim | Surgery | 3401 N Broad St # 3ppc388, Philadelphia, PA 19140 | 2015-05-14 |
| 1578941282 | Amanda Elizabeth Deliere | Surgery | 3400 N Broad St, Philadelphia, PA 19140-5104 | 2015-05-13 |
| 1649660804 | Deviney Rattigan | Surgery | 1110 Lombard St Apt 24, Philadelphia, PA 19147-1206 | 2015-01-27 |
| 1346676988 | Aviva Wallace Kaplin | Surgery | 20 E Abington Ave, Philadelphia, PA 19118-3410 | 2013-09-15 |
| 1619300571 | Roshin Thomas | Surgery | 8815 Germantown Ave Fl 2, Philadelphia, PA 19118-2722 | 2013-08-14 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 39350 |
Please comment or provide details below to improve the information on DEREK SLOANE CANNON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.