Gannon B Randolph, M.D.

NPI #1528173697 in Bentonville, Arkansas

Provider Information

NPI Number: 1528173697
Entity Type: Individual
Name: Gannon B Randolph, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Orthopaedic Surgery - Orthopaedic Surgery of the Spine
Credential: M.D.
Enumeration Date: Aug 20, 2006
Last Updated: Jul 12, 2021

Practice Location

Address: 1800 SE MOBERLY LN
City: Bentonville
State: Arkansas
ZIP Code: 72712-7017
Phone: (479) 521-2752

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Orthopaedic Surgery	207X00000X
Orthopaedic Surgery - Orthopaedic Surgery of the Spine — Orthopaedic Surgery of the Spine	207XS0117X	Primary

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