| C. Patrick Sullivan,do | |
|
200 North Thornton Vian OK 74962-0446 | |
| (918) 773-5228 | |
| (918) 773-8482 |
| Full Name | C. Patrick Sullivan,do |
|---|---|
| Speciality | Family Medicine |
| Location | 200 North Thornton, Vian, Oklahoma |
| Authorized Official Name and Position | Cary Patrick Sullivan (OWNER) |
| Authorized Official Contact | 9187735228 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| C. Patrick Sullivan,do Po Box 446 Vian OK 74962-0446 Ph: (918) 773-5228 | C. Patrick Sullivan,do 200 North Thornton Vian OK 74962-0446 Ph: (918) 773-5228 |
| NPI Number | 1003862673 |
|---|---|
| Provider Enumeration Date | 05/25/2006 |
| Last Update Date | 07/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003862673 | NPI | - | NPPES |
| 100254810E | Medicaid | OK | |
| 100254810G | Medicaid | OK | |
| 100757080G | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2148 (Oklahoma) | Primary |
Triton Health Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 128 W. Main Street, Vian, OK 74962 Phone: 918-773-5228 Fax: 918-773-8482 | |
Osu-aj Triton Health, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 128 West Main, Vian, OK 74962 Phone: 918-773-5228 Fax: 918-773-8482 | |
Triton Health Elder Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 N Thornton St, Vian, OK 74962 Phone: 918-773-5228 |