NPI 1114450822

Ryan David Mantooth, MD

Practitioner Emergency Medicine Physician Fayetteville, AR

Practice location

Address: 3215 N North Hills Blvd., Fayetteville, AR 72703
Phone: (479) 463-7102
Fax: (479) 463-5987
Mailing address: PO Box 550, Lowell, AR 72745-1900

Registered specialties (3)

Emergency Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207P00000X Licence E-13154 (AR)

Other Emergency Medicine providers in Arkansas →

Emergency Medicine Physician

Allopathic & Osteopathic Physicians Taxonomy 207P00000X Licence MD.37708 (AL)

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

Other Student in an Organized Health Care Education/Training Program providers in Arkansas →

Registry record

NPI: 1114450822
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Apr 2017
Record last updated: 9 Apr 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.