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General NPI Number Information
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NPI Number | 1326006917
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Entity Type | Individual
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Provider Name | JOHN DAVID MCCANN MD PHD
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 04/12/2024
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Provider Practice Location Address
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Address Line | 1410 FORUM KATY PKWY STE 100
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City | COLUMBIA
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State | MO
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Zip | 65203-6583
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Country | US
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Telephone | 573-441-7070
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Fax | 573-441-2288
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Provider Business Mailing Address
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Address Line | 1410 FORUM KATY PKWY STE 100
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City | COLUMBIA
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State | MO
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Zip | 65203-6583
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Country | US
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Telephone | 573-441-7070
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Fax | 573-441-2288
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 2899121205
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 2899121205
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 2022037578
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 2022037578
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License Number State | MO
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