Basic Information
| Provider Information | |||||||||
| NPI: | 1598205262 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KANNAN | ||||||||
| FirstName: | VIGNESH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | GREENWOOD LEFLORE HOSPITAL | ||||||||
| Address2: | 1401 RIVER RD | ||||||||
| City: | GREENWOOD | ||||||||
| State: | MS | ||||||||
| PostalCode: | 38930 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6624597000 | ||||||||
| FaxNumber: | 6624591310 | ||||||||
| Practice Location | |||||||||
| Address1: | GREENWOOD LEFLORE HOSPITAL | ||||||||
| Address2: | 1401 RIVER RD | ||||||||
| City: | GREENWOOD | ||||||||
| State: | MS | ||||||||
| PostalCode: | 38930 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6624597000 | ||||||||
| FaxNumber: | 6624591310 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2017 | ||||||||
| LastUpdateDate: | 09/09/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 27845 | MS | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 27845 | MS | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.