Individual
DR. ERNEST EUGENE SULLIVENT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8034 EDGERTON DRIVE, SUITE 132, USAF ACADEMY, CO 80840-2200
(719) 333-7716
(719) 333-3578
Mailing address
8034 EDGERTON DRIVE, SUITE 132, USAF ACADEMY, CO 80840-2200
(719) 333-7716
(719) 333-3578
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J8386
TX
2083P0901X
Public Health & General Preventive Medicine Physician
J8386
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131177107
—
TX
Enumeration date
06/29/2006
Last updated
07/19/2018
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