Organization
SULLIVAN FAMILY PRACTICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH W SULLIVAN M.D. (OWNER)
(615) 299-5341
Entity
Organization
Contact information
Practice address
3511 OLD CLARKSVILLE PIKE, JOELTON, TN 37080-8892
(615) 299-5341
Mailing address
3511 OLD CLARKSVILLE PIKE, JOELTON, TN 37080-8892
(615) 299-5341
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/08/2013
Last updated
07/08/2013
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