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Individual

HAROLD HAYES SULLIVAN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, MPH

Contact information

Practice address
700 ZEAGLER DR, SUITE 8, PALATKA, FL 32177-6806
(386) 328-4242
(386) 328-4244
Mailing address
700 ZEAGLER DR, SUITE 8, PALATKA, FL 32177-6806
(386) 328-4242
(386) 328-4244

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME106620
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004179900
FL
Enumeration date
01/25/2006
Last updated
05/05/2015
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