| James S Sullivan M.d. Pa | |
|
4300 Main St W Suite 16 Dothan AL 36301-1098 | |
| (334) 793-1038 | |
| (334) 615-8444 |
| Full Name | James S Sullivan M.d. Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 4300 Main St W, Dothan, Alabama |
| Authorized Official Name and Position | James S Sullivan (OWNER) |
| Authorized Official Contact | 3347931038 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James S Sullivan M.d. Pa 4300 Main St W Suite 16 Dothan AL 36301-1098 Ph: (334) 793-1038 | James S Sullivan M.d. Pa 4300 Main St W Suite 16 Dothan AL 36301-1098 Ph: (334) 793-1038 |
| NPI Number | 1083714042 |
|---|---|
| Provider Enumeration Date | 09/22/2006 |
| Last Update Date | 07/25/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083714042 | NPI | - | NPPES |
| 000010568 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5184 (Alabama) | Primary |
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