Individual
MARK STOVER SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3366 NW EXPRESSWAY, SUITE 720, OKLAHOMA CITY, OK 73112-4462
(405) 947-0676
(405) 945-4876
Mailing address
3366 NW EXPRESSWAY, SUITE 720, OKLAHOMA CITY, OK 73112-4462
(405) 947-0676
(405) 945-4876
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
8667
OK
Other
Enumeration date
11/14/2005
Last updated
08/08/2008
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