Organization
TIMOTHY SULLIVAN, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY J SULLIVAN III M.D. (MEDICAL DOCTOR)
(801) 387-4850
Entity
Organization
Contact information
Practice address
4403 HARRISON BLVD, STE# 4640, OGDEN, UT 84403-3271
(801) 387-4850
(801) 387-4855
Mailing address
4403 HARRISON BLVD, STE# 4640, OGDEN, UT 84403-3271
(801) 387-4850
(801) 387-4855
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
8263858-1205
UT
Other
Enumeration date
10/24/2012
Last updated
10/24/2012
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