Individual provider · Type 1 NPI

Paul Cannon, PA

Surgical Physician Assistant · Provo, UT

NPI number 1790212629 Active

Practice location

395 W Cougar Blvd Ste 503
Provo, UT 84604-3323

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700XPA.0005119 (CO)
Medical Physician Assistant 363AM0700XNone listed
Surgical Physician Assistant Primary 363AS0400X12917809-1206 (UT)

Surgical Physician Assistant: Definition to come...

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About NPI 1790212629

Paul Cannon, PA's National Provider Identifier is 1790212629, issued on May 23, 2017. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Provo, UT. The record was last updated on Aug 16, 2022.