Gannon B Randolph
M.D. | Orthopedic Surgery | 25+ years Exp
Medicare Enrolled 1800 Se Moberly Ln, Bentonville
Arkansas, 72712-7017
479-521-2752 479-521-4603
Maps & DirectionsGannon B Randolph is a Bentonville, Arkansas based orthopedic surgeon with 25 years of experience in Orthopedic Surgery. He completed his graduation from Oregon Health Sciences University School Of Medicine in 2000. He is also affiliated with hospitals like Northwest Medical Center-springdale and Washington Regional Medical Center. He accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Gannon B Randolph is E5957 for Orthopaedic Surgery of the Spine in Arkansas.
Gannon B Randolph is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means including the patients with musculoskeletal problems which include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. Patients with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system are also concerned.
Complete Profile:
Gannon B Randolph speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Specialization: | Orthopedic - Orthopedic Surgery |
| Credentials: | M.D. |
| Experience: | 25+ years |
| Medical School Attended: | Oregon Health Sciences University School Of Medicine |
| Graduation Year: | 2000 |
| Gender: | Male |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 1800 Se Moberly Ln, Bentonville,
Arkansas, 72712-7017 |
| Phone: | 479-521-2752 |
| Fax: | 479-521-4603 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 0941230619 |
| Enrollment ID: | I20090327000295 |
| NPI Number: | 1528173697 |
| NPI Enumeration Date: | 20 Aug, 2006 |
| NPI Last Update On: | 12 Jul, 2021 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Gannon B Randolph are as mentioned below.
| License Number | Specialization | State | Status | |
| E5957 | Orthopaedic Surgery of the Spine | Arkansas | Primary | |
| E5957 | Orthopedic Surgery | Arkansas | Secondary | |
Hospital Affiliation:
Surgeons are affiliated to many hospitals whom they worked with in the past or are presently working with. One surgeon can be affiliated to four to five hospitals at a time.
| Hospital Name (CCN) | State | Hospital Type |
| Northwest Medical Center-springdale (040022) | Springdale, AR | Acute Care Hospital |
| Washington Regional Medical Center (040004) | Fayetteville, AR | Acute Care Hospital |
| Mercy Hospital Northwest Arkansas (040010) | Rogers, AR | Acute Care Hospital |
| Siloam Springs Regional Hospital(040001) | Siloam springs, AR | Acute Care Hospital |
Group Practice:
Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name
with which Gannon B Randolph is associated with along with the number of members in that group.
| Organization Name (Group PAC ID) | Members |
| Orthopaedic Clinic Ltd (2860477189) | 37 |
Other Medical Identifiers:
Other legacy medical identifiers associated with Gannon B Randolph such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 1176259001 | Medicaid | Arkansas | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 3317 N Wimberly Dr,
Fayetteville, Arkansas |
| Zip: | 72703-4056 |
| Phone Number: | 479-521-2752 |
| Fax Number: | 479-521-4603 |
Patients can reach Gannon B Randolph at
1800 Se Moberly Ln, Bentonville, Arkansas or can
call to book an appointment on 479-521-2752.
Comments/ Reviews:
Patients can read all the reviews posted for Gannon B Randolph below. You may also share your own experience like the quality of treatment, behavior, and overall care provided by Gannon B Randolph. It will help others make informed decisions.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.