Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gannon B Randolph, MD

Individual provider Orthopaedic Surgery Physician · NPI 1528173697

Gannon B Randolph, MD is an Orthopedic Surgery in Bentonville, Arkansas. Graduated from Oregon Health Sciences University School of Medicine in 2000, 26 years ago. Practices with Ozark Orthopaedics, PA, a 57-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arkansas.

Years since qualifying
26
Trained at
Oregon Health Sciences University School of Medicine
Licensed in
AR
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1800 SE Moberly Ln
Bentonville, AR 72712-7017
Phone: (479) 521-2752
Fax: (479) 521-4603
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1101 S Horsebarn Rd, Rogers, AR 72758-8237 — (479) 271-9607

Specialties & licences

Orthopaedic Surgery of the Spine Physician (primary) Taxonomy 207XS0117X · Licence E5957 (AR)
Orthopaedic Surgery Physician Taxonomy 207X00000X · Licence E5957 (AR)

Record details

NPI number1528173697
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 20, 2006
Last updated in NPPESJuly 12, 2021
Certification dateJuly 12, 2021
Mailing address3317 N Wimberly Dr, Fayetteville, AR 72703-4056

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolOREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduated 2000 (26 years in practice)
Group practice Ozark Orthopaedics, P.A. — 57 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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