# SULLIVAN MEDICAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MADISON PRIMARY CARE AND WELLNESS CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811145758
- **Authorized official:** MARY P SULLIVAN D.O. (PHYSICIAN)
- **Authorized official phone:** (256) 830-6667

## Contact information

- **Practice address:** 1874 SLAUGHTER RD STE P, MADISON, AL 35758-5912
- **Practice address phone:** (256) 830-6667
- **Practice address fax:** (256) 830-5751
- **Mailing address:** PO BOX 1768, MADISON, AL 35758-5409
- **Mailing address phone:** (256) 830-6667
- **Mailing address fax:** (256) 830-5751

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | DO832 | AL | Yes |

## Other

- **Enumeration date:** 09/04/2008
- **Last updated:** 09/04/2008