Cannon Plastic & Reconstructive Surgery PC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

CANNON PLASTIC & RECONSTRUCTIVE SURGERY PC

Practice address

5205 Frederick St
Savannah, GA 31405-4501

Phone

(912) 354-7044

Fax

(912) 355-3066

NPI assigned

Jun 29, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Clifton L Cannon III, MD

Title

President

Phone

(912) 354-7044

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nancy Tyler Mimbs, PA-C

  • Physician Assistant
  • Orlando, FL
  • NPI 1174834139
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1093079402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15878",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314162578",
            "telephone_number": "912-354-7044",
            "fax_number": "912-355-3066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 FREDERICK ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054501",
            "telephone_number": "912-354-7044",
            "fax_number": "912-355-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANNON PLASTIC & RECONSTRUCTIVE SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-29",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "CLIFTON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-354-7044",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candler Medical Group, Inc. - Islands (SJC Med Grp Islands)
• Candler Medical Group, Inc. - Plaza D
• Candler Medical Group, Inc. - Rendon
• Candler Medical Oncology Practice, LLC
• Christen Marie Cannady, RN
• Cannon Plastic & Reconstructive Surgery PC
• Maria D Cannon, APC, NCC
• Emma O Cantey, CRNA
• Christine Camille Cantor, RBT, MAED
• Mary Claire Danielle Cantrell, PT, DPT

• Plastic Surgery Physician in Savannah, GA
• Providers in Savannah, GA by specialty
• Plastic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.