Michael W Sullivan, MD | |
1600 Spearhead Division Ave Dept 140, Fort Knox, KY 40122-5104 | |
(502) 613-4605 | |
(502) 613-4549 |
Full Name | Michael W Sullivan |
---|---|
Gender | Male |
Speciality | General Practice |
Location | 1600 Spearhead Division Ave Dept 140, Fort Knox, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275576944 | NPI | - | NPPES |
47600743623 | Medicaid | NE | |
47600743612 | Medicaid | NE | |
47600743621 | Medicaid | NE | |
47600743622 | Medicaid | NE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 20770 (Nebraska) | Secondary |
207V00000X | Obstetrics & Gynecology | 37645020 (Wisconsin) | Secondary |
208D00000X | General Practice | 30828 (Kentucky) | Primary |
Mailing Address | Practice Location Address |
---|---|
Michael W Sullivan, MD 1600 Spearhead Division Ave Dept 140, Fort Knox, KY 40122-5104 Ph: (502) 613-4605 | Michael W Sullivan, MD 1600 Spearhead Division Ave Dept 140, Fort Knox, KY 40122-5104 Ph: (502) 613-4605 |
Dr. Vanessa Jane Shank, M.D. General Practice Medicare: Medicare Enrolled Practice Location: 289 Ireland Ave, Ireland Army Community Hospital, Fort Knox, KY 40121 Phone: 502-624-9864 |