Provider Demographics
NPI:1265305684
Name:FENNEL, ROBERT COLE (DC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:COLE
Last Name:FENNEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:647 MADISON 8739
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72740-9573
Mailing Address - Country:US
Mailing Address - Phone:479-841-2314
Mailing Address - Fax:
Practice Address - Street 1:2863 E MILLENNIUM DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-6513
Practice Address - Country:US
Practice Address - Phone:479-444-7332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR12406111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty