Individual
JOHN PATRICK SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
850 W BARAGA AVE, MARQUETTE, MI 49855-4550
(906) 449-3000
Mailing address
1218 S BROADWAY, SUITE 310, LEXINGTON, KY 40504-2759
(859) 219-0542
(859) 219-9433
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
39464
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64098940
—
KY
Enumeration date
04/27/2006
Last updated
08/03/2022
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