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Individual

STEVE HADEN SULLIVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.D.

Contact information

Practice address
208 MAIN ST., HORATIO, AR 71842
(870) 832-2561
(870) 832-5405
Mailing address
414 W HIGHWAY 70 B, DE QUEEN, AR 71832-2928
(870) 584-4676
(870) 832-5405

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
9163
OK
183500000X
Pharmacist
Primary
PD06508
AR

Other

Enumeration date
10/27/2006
Last updated
07/08/2007
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