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Organization

SULLIVAN PSYCHIATRIC GROUP, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN PAUL SULLIVAN MD (OWNER)
(502) 451-5121
Entity
Organization

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, SUITE 101, LOUISVILLE, KY 40213-1988
(502) 451-5121
(502) 451-5125

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
21704
KY

Other

Enumeration date
09/26/2013
Last updated
11/06/2024
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