Kathryn Sullivan, MD | |
60 Mdg, 101 Bodin Circle, Travis Afb, CA 94535-1800 | |
(707) 423-7401 | |
Not Available |
Full Name | Kathryn Sullivan |
---|---|
Gender | Female |
Speciality | Urology |
Experience | 19 Years |
Location | 60 Mdg, Travis Afb, California |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1487700167 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | 0101249048 (Virginia) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Fauquier Hospital | Warrenton, VA | Hospital |
Peninsula Regional Medical Center | Salisbury, MD | Hospital |
Novant Health Uva Health System Culpeper Med Cente | Culpeper, VA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Fauquier Physician Practices Llc | 6406083104 | 35 |
Tidalhealth Specialty Care Llc | 7113340845 | 192 |
Entity Name | Fauquier Physician Practices Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770916983 PECOS PAC ID: 6406083104 Enrollment ID: O20131227001299 |
Mailing Address | Practice Location Address |
---|---|
Kathryn Sullivan, MD 60 Mdg, 101 Bodin Circle, Travis Afb, CA 94535-1800 Ph: (720) 220-4403 | Kathryn Sullivan, MD 60 Mdg, 101 Bodin Circle, Travis Afb, CA 94535-1800 Ph: (707) 423-7401 |
Dr. Yurong Mai, MD Urology Medicare: Medicare Enrolled Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-7402 | |
Dr. Joseph William Pugh, M.D. Urology Medicare: Medicare Enrolled Practice Location: 101 Bodin Cir, 60 Mdg/ Sgcxu, Travis Afb, CA 94535 Phone: 707-423-7401 | |
Dr. Alexander Lo, MD Urology Medicare: Medicare Enrolled Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-7402 |