Organization
C. PATRICK SULLIVAN,DO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARY PATRICK SULLIVAN D.O. (OWNER)
(918) 773-5228
Entity
Organization
Contact information
Practice address
200 NORTH THORNTON, VIAN, OK 74962-0446
(918) 773-5228
(918) 773-8482
Mailing address
PO BOX 446, VIAN, OK 74962-0446
(918) 773-5228
(918) 773-8482
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2148
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100254810E
—
OK
05
—
100254810G
—
OK
05
—
100757080G
—
OK
Enumeration date
05/25/2006
Last updated
07/08/2008
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