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Dr. Jack Russell Cannon II, MD
Diagnostic Radiology Physician in Edgefield, South Carolina
NPI 1619030327

Jack Russell Cannon II is a Diagnostic Radiology Physician based in Aiken, SC and is specialized in Diagnostic Radiology. Jack Russell Cannon II practices in Edgefield, SC and has the professional credentials of MD. The NPI Number for Jack Russell Cannon II is 1619030327 and holds a License No. 9533 (South Carolina).

The current practice location address for Jack Russell Cannon II is 300 Ridge Medical Plaza, Edgefield, SC and can be reached out via phone at 803-637-1175.

Location: 300 Ridge Medical Plaza, Edgefield, SC, 29801-2702
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1619030327
Provider Name
Jack Russell Cannon II
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
300 Ridge Medical Plaza, Edgefield, SC, 29801-2702
Phone Number
803-637-1175
Fax Number
Provider Enumeration Date
12/18/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
095332 05 SC
institution
Provider Business Practice Location Address Details
Address
300 Ridge Medical Plaza
City
Edgefield
State
South Carolina
Zip
29824-9986
Phone Number
803-637-1175
Fax Number
person
Provider Business Mailing Address Details
Address
300 Ridge Medical Plaza
City
Edgefield
State
South Carolina
Zip
29824-9986
Phone Number
803-637-1175
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
9533 (South Carolina)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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