Provider Demographics
NPI:1538280011
Name:CHAMPION, SEAN D (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:D
Last Name:CHAMPION
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:303 PROFESSIONAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:ARKADELPHIA
Mailing Address - State:AR
Mailing Address - Zip Code:71923-5317
Mailing Address - Country:US
Mailing Address - Phone:870-403-1225
Mailing Address - Fax:870-497-1655
Practice Address - Street 1:303 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:ARKADELPHIA
Practice Address - State:AR
Practice Address - Zip Code:71923-5317
Practice Address - Country:US
Practice Address - Phone:870-403-1225
Practice Address - Fax:870-497-1655
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE5235207Q00000X, 208600000X
OK28998208600000X
GA055112208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine