Individual
DR. JOSEPH WYNN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
600 ZEAGLER DR, PALATKA, FL 32177-3811
(386) 325-8140
(386) 325-8848
Mailing address
PO BOX 102222, ATLANTA, GA 30368-2222
(239) 274-8200
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
OS5691
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064451000
—
FL
Enumeration date
09/29/2005
Last updated
05/24/2024
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