Individual
DR. JASON MURRAY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
668 SKYLINE DR, JACKSON, TN 38301-3951
(731) 424-2414
(731) 424-4444
Mailing address
668 SKYLINE DR, JACKSON, TN 38301-3951
(731) 424-2414
(731) 424-4444
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD0031354
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3838587
—
TN
Enumeration date
01/10/2006
Last updated
11/15/2007
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