Individual
DR. JOHN P SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7740 POINT MEADOWS DR, SUITE 3A, JACKSONVILLE, FL 32256-9179
(904) 527-3577
(904) 527-3514
Mailing address
7740 POINT MEADOWS DR, SUITE 3A, JACKSONVILLE, FL 32256-9179
(904) 527-3577
(904) 527-3514
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME0064370
FL
207WX0107X
Retina Specialist (Ophthalmology) Physician
37090
GA
207WX0107X
Retina Specialist (Ophthalmology) Physician
ME64370
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00578113A
—
GA
05
—
373365300
—
FL
Enumeration date
07/22/2005
Last updated
04/05/2017
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