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Individual

JERRY N CAVANEAU

Active
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Individual

JERRY N CAVANEAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E2550
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007533273
AETNA
AR
01
—
0904380019
DMERC
AR
05
—
140550001
—
AR
01
—
1876582001
CIGNA
AR
01
—
19427000000
QUALCHOICE
AR
01
—
522838
HEALTHLINK
AR
01
—
5L520
BCBS
AR
Enumeration date
02/13/2006
Last updated
05/28/2008
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