Individual
MR. DONALD RICHARD SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
119140 RICK JONES WAY, BUTTE, MT 59750-9722
(406) 496-9890
(406) 496-9794
Mailing address
119140 RICK JONES WAY, BUTTE, MT 59750-9722
(406) 496-9890
(406) 496-9794
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
#11
MT
Other
Enumeration date
04/06/2007
Last updated
07/08/2007
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