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Organization

VINCENT E. SULLIVAN MD PC

Active
Other names
Surgery Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
DR. VINCENT EDWARD SULLIVAN M.D. (OWNER)
(641) 437-1576
Entity
Organization

Contact information

Practice address
19878 SAINT JOSEPH DR, CENTERVILLE, IA 52544-8850
(641) 437-1576
(641) 437-4205
Mailing address
19878 SAINT JOSEPH DR, P.O. BOX 160, CENTERVILLE, IA 52544-8850
(641) 437-1576
(641) 437-4205

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
18213
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0186270
IA
Enumeration date
11/27/2007
Last updated
11/27/2007
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