Individual
MR. TIMOTHY MARK SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
9951 E EL MORO AVE, MESA, AZ 85208-5869
(602) 570-6428
Mailing address
5432 E SOUTHERN AVE, MESA, AZ 85206-2772
(480) 325-3275
(480) 981-9123
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
AZ
Other
Enumeration date
01/04/2008
Last updated
11/05/2008
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