Individual
RYAN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
7301 ROGERS AVE, FORT SMITH, AR 72903-4100
(479) 314-6241
(479) 452-0275
Mailing address
7301 ROGERS AVE, FORT SMITH, AR 72903-4100
(479) 314-6241
(479) 452-0275
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4817
OK
207P00000X
Emergency Medicine Physician
Primary
E-8248
AR
Other
Enumeration date
08/27/2009
Last updated
12/02/2022
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