Individual
DR. JOHN PAUL SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4011 GARDINER POINT DR STE 101, LOUISVILLE, KY 40213-1988
(502) 451-5121
(502) 451-5125
Mailing address
4011 GARDINER POINT DR STE 101, LOUISVILLE, KY 40213-1988
(502) 451-5121
(502) 451-5125
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
KY21704
KY
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
KY21704
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100012920A
—
IN
05
—
64217045
—
KY
Enumeration date
07/27/2006
Last updated
01/09/2020
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