Individual
DR. JORDAN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2301 N LAKE DR, PODIATRIC RESIDENCY OFFICE, MILWAUKEE, WI 53211-4508
(402) 310-7374
Mailing address
2301 N LAKE DR, PODIATRIC RESIDENCY OFFICE, MILWAUKEE, WI 53211-4508
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
18096
WI
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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