Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | E-13258 | AR |
N | 207X00000X | Orthopaedic Surgeon | MD60943546 | WA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD60943546 | WA |
NPI | 1700204997 |
---|---|
Provider Name | Chelsea Sullivan Mathews |
First Address | Little Rock, AR 72225-1420 |
Second Address | Little Rock, AR 72205-7101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2014 |
Last Update Date | 12/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1700204997 | (05) | WA |