Organization
THOMAS J. SULLIVAN, JR. MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS J SULLIVAN JR. MD (PHYSICIAN/OWNER)
(864) 225-9566
Entity
Organization
Contact information
Practice address
803 N FANT ST, SUITE 2-C, ANDERSON, SC 29621-5700
(864) 225-9566
(864) 225-9568
Mailing address
803 N FANT ST, SUITE 2-C, ANDERSON, SC 29621-5700
(864) 225-9566
(864) 225-9568
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4610
—
SC
Enumeration date
10/25/2006
Last updated
10/11/2007
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