Individual
DR. KATHLEEN CAMPBELL SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
PEACEHEALTH HOSPITAL MEDICINE, 3377 RIVERBEND DRIVE, SPRINGFIELD, OR 97477-8803
(541) 222-6389
(541) 222-6385
Mailing address
PEACEHEALTH HOSPITAL MEDICINE, 3377 RIVERBEND DRIVE, SPRINGFIELD, OR 97477-8803
(541) 222-6389
(541) 222-6385
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
51683
CO
207R00000X
Internal Medicine Physician
LL18647
OR
208M00000X
Hospitalist Physician
Primary
MD158343
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023074
KAISER COMMERCIAL NUMBER
CO
05
—
500721348
—
OR
05
—
69008744
—
CO
Enumeration date
06/03/2009
Last updated
09/01/2023
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