Individual
DR. ERIC M SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
920 COUNTRY CLUB RD, SUITE 200A, EUGENE, OR 97401-6024
(541) 342-2134
(541) 684-3074
Mailing address
PO BOX 1648, EUGENE, OR 97440-1648
(541) 342-2134
(541) 684-3074
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD161287
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500666109
—
OR
Enumeration date
09/20/2006
Last updated
09/12/2014
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