Organization
JAMES S SULLIVAN M.D. PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES S SULLIVAN M.D. (OWNER)
(334) 793-1038
Entity
Organization
Contact information
Practice address
4300 MAIN ST W, SUITE 16, DOTHAN, AL 36301-1098
(334) 793-1038
(334) 615-8444
Mailing address
4300 MAIN ST W, SUITE 16, DOTHAN, AL 36301-1098
(334) 793-1038
(334) 615-8444
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5184
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000010568
—
AL
Enumeration date
09/22/2006
Last updated
07/25/2007
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