Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Domenic Michael Canonico, MD

Individual provider Plastic Surgery within the Head & Neck (Otolaryngology) Physician · NPI 1770551640

Domenic Michael Canonico, MD is an Otolaryngology in Tullahoma, Tennessee. Graduated from Vanderbilt University School of Medicine in 1987, 39 years ago. Accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
39
Trained at
Vanderbilt University School of Medicine
Licensed in
TN
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

507 NW Atlantic St
Tullahoma, TN 37388-3504
Phone: (931) 393-4332
Fax: (931) 393-2304
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery within the Head & Neck (Otolaryngology) Physician (primary) Taxonomy 207YX0007X · Licence 18819 (TN)

Record details

NPI number1770551640
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 8, 2006
Last updated in NPPESJuly 14, 2015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOTOLARYNGOLOGY
Medical schoolVANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Graduated 1987 (39 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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