Organization
SCOT A SULLIVAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOT SULLIVAN MD (OWNER)
(503) 841-7593
Entity
Organization
Contact information
Practice address
2020 E 15TH ST STE B, EDMOND, OK 73013-6749
(405) 348-9993
Mailing address
1025 NW COUCH ST UNIT 819, PORTLAND, OR 97209-4132
(503) 841-7593
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
20157
OK
Other
Enumeration date
06/30/2017
Last updated
06/30/2017
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