DR. ROBERT DAVID CANNON (NPI# 1104806702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104806702 |
Entity Type | Individual |
Full Name | DR. ROBERT DAVID CANNON |
Credential | M.D. |
Practice Address |
3715 N Business Dr Suite #101 Fayetteville AR 72703-5204 |
Practice Telephone | 4795822800 |
Practice Fax Number | 4795822922 |
Mailing Telephone | 4795822800 |
Mailing Fax Number | 4795822922 |
Enumeration Date | 2006-01-19 |
Last Update Date | 2011-04-11 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
C-8066 | AR | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AR | 127592001 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770006942 | Robert C. Cannon | Registered Nurse | 60875 E Eagle Mountain Dr, Tucson, AZ 85739-5939 | 2017-07-19 |
1013364306 | Robert Cannon | Non-emergency Medical Transport (VAN) | 40 Silver St, Rochester, NY 14611-2208 | 2016-05-17 |
1033528351 | Robert Darrell Cannon | Urology | 2717 Ptarmigan Dr Apt 2, Walnut Creek, CA 94595-3195 | 2014-08-12 |
1336552173 | Robert Clayton Cannon | Dentist | 8950 Main Street, Suite 120, Woodstock, GA 30188 | 2014-06-10 |
1952605552 | Robert Cannon | Contractor | 4611 E Palo Verde Dr, Phoenix, AZ 85018-1258 | 2010-12-23 |
1881636900 | Robert Orman Cannon IIi | Internal Medicine | 727 Holly Oak Dr, Palo Alto, CA 94303-4143 | 2006-06-12 |
1346882792 | Robert W Cannon | Pharmacist | 10090 Chester Ave, Cleveland, OH 44106-1600 | 2019-10-16 |
1811400781 | Robert Lee Cannon | Behavior Technician | 453 King St, Cocoa, FL 32922-7621 | 2017-11-14 |
1215373139 | Robert Michael Cannon | Family Medicine | 1901 Mission 66, Vicksburg, MS 39180-3711 | 2013-05-18 |
1902049398 | Robert Davis Cannon | Clinical Nurse Specialist | 5665 Peachtree Dunwoody Rd Ne, Atlanta, GA 30342-1764 | 2009-04-14 |
Street Address |
3715 N BUSINESS DR SUITE #101 |
City | FAYETTEVILLE |
State | AR |
Zip Code | 72703-5204 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518564616 | Luke Rallens | Case Manager/Care Coordinator | 3715 N Business Dr, Fayetteville, AR 72703-5204 | 2020-10-02 |
1174163950 | Elizabeth Dena Bell | Licensed Practical Nurse | 3715 N Business Dr, Fayetteville, AR 72703-5204 | 2020-01-09 |
1447740535 | Shamekia Daniels | Case Manager/Care Coordinator | 3715 N Business Dr, Fayetteville, AR 72703-5204 | 2018-05-14 |
1275035024 | Courtney Denise Bland | Case Manager/Care Coordinator | 3715 N Business Dr, Fayetteville, AR 72703-5204 | 2018-03-07 |
1831628528 | Lisa Calabrese | Registered Nurse | 3715 N Business Dr, Fayetteville, AR 72703-5204 | 2017-06-07 |
1376072215 | Ashley Michelle Patton | Counselor | 3715 N Business Dr, Fayetteville, AR 72703-5204 | 2017-06-05 |
1780111047 | Sean Patton | Health Educator | 3715 N Business Dr, Fayetteville, AR 72703-5204 | 2017-05-17 |
1598291478 | Trestletree, LLC | Social Worker | 3715 N Business Dr, Suite 202, Fayetteville, AR 72703-5204 | 2017-05-11 |
1427597673 | Melinda Farris | Case Manager/Care Coordinator | 3715 N Business Dr, Suite104, Fayetteville, AR 72703-5204 | 2017-02-21 |
1356885057 | Laquita Owens | Case Manager/Care Coordinator | 3715 N Business Dr, Fayetteville, AR 72703-5204 | 2016-12-14 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477154391 | Margaret Sorrells | Pharmacist | 3909 N Mall Ave Attn:pharmacy, Fayetteville, AR 72703 | 2020-11-06 |
1497369631 | Justin A Rand | Massage Therapist | 88 W Colt Square Dr, Fayetteville, Ar 72703, Fayetteville, AR 72703 | 2020-09-04 |
1235777558 | Washington Regional Medical System | Specialist | 3264 N North Hills Blvd, Fayetteville, AR 72703 | 2019-12-17 |
1760024582 | Haley Brooke Thompson | Occupational Therapist | 2474 E Joyce Blvd Ste 2, Null, Fayetteville, AR 72703 | 2019-10-14 |
1306492129 | Bhg L, LLC | Clinic/Center | 8 Colt Square Drive, Fayetteville, AR 72703 | 2019-08-16 |
1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
1821574815 | Toni Myer | Nurse Practitioner | 3 E Appleby Rd Ste 101, Fayetteville, AR 72703 | 2018-07-13 |
1306340393 | Josh Kelfer | Student in an Organized Health Care Education/Training Program | 1125 North College Avenue, Fayetteville, AR 72703 | 2018-03-22 |
1649726449 | Vantage Point of Nwa | Community/Behavioral Health | 4171 N. Crossover Rd, Fayetteville, AR 72703 | 2016-08-31 |
1386097137 | Jason Nordstrom | Speech-Language Pathologist | 2664 N Valencia Ave, Fayetteville, AR 72703 | 2016-07-18 |
Find all providers in zip 72703 |
Taxonomy Code | 208VP0014X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pain Medicine |
Specialization | Interventional Pain Medicine |
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578193355 | Regenerative Spine and Pain Specialists | Pain Medicine | 874 Lanier Ave W Ste 250, Fayetteville, GA 30214-7662 | 2020-01-22 |
1295032407 | Interventional Pain Specialists of Nwa, Pllc | Pain Medicine | 509 E Millsap Rd Ste 109, Fayetteville, AR 72703-4862 | 2011-02-24 |
1063628675 | Southside Medical & Physical Therapy, LLC | Pain Medicine | 1415 Highway 85 N, Suite 310-314, Fayetteville, GA 30214-4035 | 2007-05-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427662345 | Bentonville Ambulatory Surgery Center, LLC | Pain Medicine | 2902 We Mid-cities Dr, Bentonville, AR 72712 | 2020-09-08 |
1932619327 | Fort Neuro | Pain Medicine | 1501 S Waldron Rd Ste 109, Fort Smith, AR 72903-2568 | 2017-10-11 |
1891061040 | Vadim Petrov-kondratov | Pain Medicine | 180 Medical Park Pl Ste 102, Hot Springs, AR 71901-8066 | 2012-03-31 |
1356635486 | Mohamed Tolba | Pain Medicine | 1080 Pats Ln, Conway, AR 72032-4754 | 2011-06-06 |
1376733824 | Hot Springs Interventional Pain Management | Pain Medicine | 1 Mercy Ln Ste 304, Hot Springs, AR 71913 | 2007-07-31 |
1558447599 | White River Health System, Inc. | Pain Medicine | 1700 Harrison St Ste T, Batesville, AR 72501-7315 | 2006-10-31 |
1699781427 | Sunil Gera | Pain Medicine | 2601 Southwest Square, Jonesboro, AR 72401 | 2006-08-01 |
1386641520 | Sunder Krishnan | Pain Medicine | 14918 Cantrell Rd, Little Rock, AR 72223-4248 | 2005-07-01 |
1568465698 | Donald L Boos Jr. | Pain Medicine | 307 Carpenter Dam Rd Ste F, Hot Springs, AR 71901-8282 | 2005-05-23 |
1104306919 | Comprehensive Pain Care Pa | Pain Medicine | 201 N Slemons St, Monticello, AR 71655-4326 | 2018-08-21 |
Find all providers with the same taxonomy |
City | FAYETTEVILLE |
Zip Code | 72703 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.