Provider Demographics
NPI:1366070765
Name:SULLIVAN, ELIZABETH CAREY (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CAREY
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4208 N RODNEY PARHAM RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-2462
Mailing Address - Country:US
Mailing Address - Phone:501-228-7200
Mailing Address - Fax:501-228-2285
Practice Address - Street 1:4208 N RODNEY PARHAM RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-2462
Practice Address - Country:US
Practice Address - Phone:501-228-7200
Practice Address - Fax:501-228-2285
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-31
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-16752207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine