Organization
KERRY P SULLIVAN OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY P SULLIVAN OD (OPTOMETRIST)
(252) 794-3381
Entity
Organization
Contact information
Practice address
106 N KING ST, WINDSOR, NC 27983-6863
(252) 794-3381
Mailing address
PO BOX 160, WINDSOR, NC 27983-0160
(252) 794-3381
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1268
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890979E
—
NC
Enumeration date
05/19/2008
Last updated
05/19/2008
Update your record
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