Individual
THOMAS C. SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 CRESTWOOD CIR, SUITE L, MENA, AR 71953-5511
(479) 394-1414
(479) 394-2612
Mailing address
311 MORROW ST N, MENA, AR 71953-2516
(479) 394-6100
(479) 394-4577
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
A41748
CA
Other
Enumeration date
06/30/2006
Last updated
02/07/2012
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