Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GANNON B RANDOLPH, M.D.
ActiveGANNON B RANDOLPH, M.D. is a Orthopaedic Surgery of the Hand healthcare provider located in BENTONVILLE, Arkansas. NPI 1528173697 is currently active in the NPPES registry. Verify at CMS.
Orthopaedic Surgery of the Hand · BENTONVILLE, AR
Registration Details
- NPI Number
- 1528173697
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 20, 2006 (20.028571934862 yrs)
- Last Updated
- Jul 12, 2021
- Licenses
-
E5957 (AR)E5957 (AR)
Practice Information
- Address
-
1800 SE MOBERLY LNBENTONVILLE, AR, 727127017Browse AR providers · Browse ZIP 72712
- Phone
- 4795212752
- Fax
- 4795214603
- Primary Specialty
-
Orthopaedic Surgery of the Hand
207XS0117X
- Additional Specialty
- Orthopaedic Surgery of the Hand
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.