Provider Type Icon

RYAN DAVID MANTOOTH MD NPI 1114450822


NPI Information

NPI: 1114450822
Provider Name: RYAN DAVID MANTOOTH, MD
Classification: Emergency Medicine - 207P00000X
Entity Type: Individual
Organization: WASHINGTON REGIONAL MEDICAL SYSTEM

PECOS Registration: Yes

Address:
3215 N NORTH HILLS BLVD.
FAYETTEVILLE, AR
ZIP 72703
Phone: (479) 463-7102
Get Directions

Ryan David Mantooth, MD is an emergency medicine in Fayetteville, AR with 7 years of experience. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. Ryan David Mantooth, MD NPI is 1114450822. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Graduation Year:2017

The provider's business location address is:

3215 N NORTH HILLS BLVD.
FAYETTEVILLE, AR
ZIP 72703
Phone: (479) 463-7102
Fax: (479) 463-5987

The NPI 1114450822 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/10/2017 and was last updated on 4/9/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207P00000XEmergency MedicineMD.37708ALABAMANo
2207P00000XEmergency MedicineE-13154ARKANSASYes
3390200000XStudent in an Organized Health Care Education/Training ProgramNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.