Individual
MR. WILLIAM MICAIAH SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
1030 JEFFERSON AVE, MEMPHIS, TN 38104-2127
(901) 523-8990
Mailing address
1030 JEFFERSON AVE, MEMPHIS, TN 38104-2127
(901) 523-8990
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R885943
MS
Other
Enumeration date
08/09/2010
Last updated
08/09/2010
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