Individual
JERRY N CAVANEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4411 HIGHWAY 5 N, BRYANT, AR 72022-7005
(501) 847-0289
Mailing address
4411 HIGHWAY 5 N, BRYANT, AR 72022-7005
(501) 847-0289
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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