Individual
JULIE GAIL SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1615 S EUCALYPTUS AVE, SUITE 210, BROKEN ARROW, OK 74012-6159
(918) 254-6822
(918) 254-6823
Mailing address
1615 S EUCALYPTUS AVE, SUITE 210, BROKEN ARROW, OK 74012-6159
(918) 254-6822
(918) 254-6823
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
23824
OK
Other
Enumeration date
06/20/2005
Last updated
01/24/2017
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