Provider Demographics
NPI:1194980748
Name:SULLIVAN, ELIZABETH ANN (M D)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:LAMBIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8201 CANTRELL RD
Mailing Address - Street 2:STE 265
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-2453
Mailing Address - Country:US
Mailing Address - Phone:501-661-0077
Mailing Address - Fax:
Practice Address - Street 1:8201 CANTRELL RD
Practice Address - Street 2:STE 265
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72227-2453
Practice Address - Country:US
Practice Address - Phone:501-661-0077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS226522084N0400X
NC006202084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology