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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DOMENIC MICHAEL CANONICO, M.D.

Active

DOMENIC MICHAEL CANONICO, M.D. is a Plastic Surgery within the Head & Neck healthcare provider located in TULLAHOMA, Tennessee. NPI 1770551640 is currently active in the NPPES registry. Verify at CMS.

Plastic Surgery within the Head & Neck · TULLAHOMA, TN

Registration Details

NPI Number
1770551640
Provider Type
Individual
Gender
Male
NPI Issued
Mar 8, 2006 (20.246894872704 yrs)
Last Updated
Jul 14, 2015
License
18819 (TN)

Practice Information

Address
507 NW ATLANTIC ST
TULLAHOMA, TN, 373883504
Browse TN providers · Browse ZIP 37388
Phone
9313934332
Fax
9313932304
Primary Specialty
Plastic Surgery within the Head & Neck
207YX0007X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.