# SULLIVAN FAMILY PRACTICE, LLC

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

## Provider details

- **NPI number:** 1770502981
- **Authorized official:** MRS. SUSAN LYNN HELMAN (ADMINISTRATOR)
- **Authorized official phone:** (812) 268-3318

## Contact information

- **Practice address:** 2229 MARY SHERMAN DR, SULLIVAN, IN 47882-7633
- **Practice address phone:** (812) 268-3318
- **Practice address fax:** (812) 268-4017
- **Mailing address:** 2229 MARY SHERMAN DR, PO BOX 230, SULLIVAN, IN 47882-7633
- **Mailing address phone:** (812) 268-3318
- **Mailing address fax:** (812) 268-4017

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 01036108 | IN | Yes |
| 261QR1300X | Rural Health Clinic/Center | 01036108 | IN | — |

## Other

- **Enumeration date:** 07/19/2006
- **Last updated:** 10/26/2009