Cannon, Robert David

Cannon, Robert David is an sole proprietor health care provider with primary practice located at 1708 E Joyce Blvd Ste 2 , Fayetteville AR 72703-5250. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Cannon, Robert David can be contacted via phone (479) 582-2800.

Contact Information

Primary practice address
1708 E Joyce Blvd Ste 2 Fayetteville AR 72703-5250
Phone: (479) 582-2800
Fax: (479) 582-2922
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X C8066 Arkansas
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X C-8066 Arkansas

Profile Details

NPI number 1104806702
LBN Legal business name Cannon, Robert David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 19th, 2006
Last updated Mar 12th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104806702 NPPES
Arkansas MEDICAID 127592001

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