Individual
CODY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1530 LONE OAK RD, PADUCAH, KY 42003-7900
(270) 444-2444
Mailing address
550 S JACKSON ST FL 3, LOUISVILLE, KY 40202-1622
(502) 852-5666
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.165650
IL
207R00000X
Internal Medicine Physician
Primary
57052
KY
207R00000X
Internal Medicine Physician
TP934
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2017
Last updated
04/19/2026
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