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JERRY N CAVANEAU M.D.

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1639142284

Individual Registrant:
 JERRY N CAVANEAU M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
4411 HIGHWAY 5 N  BRYANT, AR 72022-7005 US
Tel: 501-847-0289  Fax: --

Contact information for business:
4411 HIGHWAY 5 N  BRYANT, AR 72022-7005 US
Tel: 501-847-0289  Fax: --

Registration Information:
NPI: 1639142284
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
ARE2550

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
DMERC0904380019AR01
BCBS5L520AR01
HEALTHLINK522838AR01
AETNA0007533273AR01
QUALCHOICE19427000000AR01
140550001AR05
CIGNA1876582001AR01




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