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

Dr. Jack Russell Cannon II, MD

Individual provider Diagnostic Radiology Physician · NPI 1619030327

Dr. Jack Russell Cannon II, MD is a Diagnostic Radiology Physician in Edgefield, South Carolina. Licensed in South Carolina. Registered with an NPI since 2006.

Licensed in
SC
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

300 Ridge Medical Plz
Edgefield, SC 29824-9986
Phone: (803) 637-1175
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 9533 (SC)

Record details

NPI number1619030327
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedDecember 18, 2006
Last updated in NPPESJuly 9, 2007