Individual
DR. CLARENCE FRANCIS SULLIVAN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
450 SOUTHLAND DR STE A, LEXINGTON, KY 40503-1831
(859) 278-7282
Mailing address
450 SOUTHLAND DR STE A, LEXINGTON, KY 40503-1831
(859) 278-7282
(859) 278-7299
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
KY008745
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KY008745
KY LICENSE
KY
Enumeration date
12/23/2020
Last updated
12/23/2020
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