Curtis Ray Canning, M.D.
Individual provider Active NPI Psychiatry Physician · North Logan, UT
NPI 1487698676 · NPPES record last updated Oct 11, 2007
Key facts
- NPI
- 1487698676
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 159037-1205 (UT)
- Practice address
- 1750 Research Park Way
Suite 104
North Logan, UT 84341-1955 - Phone
- (435) 753-0272
- Fax
- (435) 753-2252
- NPI assigned
- Jun 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 159037-1205 | UT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robert S. Cook, PH.D., PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 159037-1205 | UT | Yes |
Addresses
Primary practice location
1750 Research Park Way
Suite 104
North Logan, UT 84341-1955
Mailing address
PO Box 6340
North Logan, UT 84341-6340
Phone (435) 753-0272
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36092 | Other | UT | DMBA |
| 1248 | Other | UT | PEHP |
| 107006790102 | Other | UT | SELECTHEALTH |
| 870378139CA1 | Other | UT | EMIA |
Other providers in North Logan, UT
- Cache Valley Pharmacare LLC
- Cache Valley Pharmacare LLC
- Cache Valley Specialty Hospital
- Cache Valley Surgical Consultants, PC
- Camille Webb LLC
- Cannon Chiropractic LLC
- Jason M Christiansen
- Dorothy Clayton Cobia
- Skye Cole
- Consulting Outside of the Box a Professional Corporation
All providers in North Logan, UT · Psychiatry Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.