Individual
SCOTT SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1432 KIMBROUGH RD, GERMANTOWN, TN 38138-2405
(901) 767-4499
Mailing address
1432 KIMBROUGH RD, GERMANTOWN, TN 38138-2405
(901) 767-4499
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
63308
TN
Other
Enumeration date
05/11/2017
Last updated
02/18/2025
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