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MR. KENNETH W SULLIVAN M.D.

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1376637215

Individual Registrant:
MR. KENNETH W SULLIVAN M.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
3511 OLD CLARKSVILLE PIKE  JOELTON, TN 37080-8892 US
Tel: 615-299-5341  Fax: 615-299-5386

Contact information for business:
PO BOX 57  SPRINGFIELD, TN 37172-0057 US
Tel: 615-299-5341  Fax: 615-299-5386

Registration Information:
NPI: 1376637215
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
TN27509

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS TN - Page 1



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