Provider Demographics
NPI:1003689571
Name:KILLIAN, PAUL RYAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:RYAN
Last Name:KILLIAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 684
Mailing Address - Street 2:
Mailing Address - City:CALICO ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72519-0684
Mailing Address - Country:US
Mailing Address - Phone:870-404-2830
Mailing Address - Fax:
Practice Address - Street 1:624 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-2955
Practice Address - Country:US
Practice Address - Phone:870-508-1377
Practice Address - Fax:870-508-1315
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD108011835C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835C0205XPharmacy Service ProvidersPharmacistCritical Care