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General NPI Number Information
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NPI Number | 1770594723
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Entity Type | Individual
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Provider Name | SARA M CANNON MD
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Gender | Female
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 300 S 8TH ST STE 480W
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City | MURRAY
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State | KY
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Zip | 42071-2403
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Country | US
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Telephone | 270-762-1562
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Fax | 270-752-2864
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Provider Business Mailing Address
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Address Line | 300 S 8TH ST STE 480W
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City | MURRAY
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State | KY
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Zip | 42071-2403
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Country | US
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Telephone | 270-762-1321
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Fax |
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036116347
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 61054
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License Number State | KY
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