Healthcare Provider Details

I. General information

NPI: 1568475598
Provider Name (Legal Business Name): JOHN H. CANNON III DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 W FERGUSON RD
MOUNT PLEASANT TX
75455-2925
US

IV. Provider business mailing address

1055 CLARKSVILLE STREET SUITE 185
PARIS TX
75460
US

V. Phone/Fax

Practice location:
  • Phone: 903-595-4144
  • Fax: 903-595-6821
Mailing address:
  • Phone: 903-905-4945
  • Fax: 903-905-4949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberL1282
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: