# SULLIVAN PSYCHIATRIC GROUP, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366879025
- **Authorized official:** JOHN PAUL SULLIVAN MD (OWNER)
- **Authorized official phone:** (502) 451-5121

## Contact information

- **Practice address:** 4011 GARDINER POINT DR STE 101, LOUISVILLE, KY 40213-1988
- **Practice address phone:** (502) 451-5121
- **Practice address fax:** (502) 451-5125
- **Mailing address:** 4011 GARDINER POINT DR, SUITE 101, LOUISVILLE, KY 40213-1988
- **Mailing address phone:** (502) 451-5121
- **Mailing address fax:** (502) 451-5125

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | 21704 | KY | Yes |

## Other

- **Enumeration date:** 09/26/2013
- **Last updated:** 11/06/2024