Individual
DR. RICHARD LEE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1350
(208) 422-1332
Mailing address
921 HEARTLAND DR, NAMPA, ID 83686-8157
(208) 422-1350
(208) 422-1332
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
M5112
ID
Other
Enumeration date
08/24/2006
Last updated
07/21/2022
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