National Provider Identifier Database

TIMOTHY J SULLIVAN III, MD – NPI #1023012911
Allergy

A physician who specializes in the diagnosis, treatment, and management of allergies.


Contact Information

TIMOTHY J SULLIVAN III, MD
4403 HARRISON BLVD.
STE 4640
OGDEN, UT84403-3304
Phone: 801-387-4850
Fax: 801-387-4855
Website:
Specialty Taxonomy Code
* Allergy 207KA0200X

* Indicates primary specialty

NPI Profile & details for TIMOTHY J SULLIVAN III

NPI Number 1023012911
Credentials MD
Entity Individual
Enumeration date 06/08/2005
Last updated 06/03/2015 - About 11 years ago
Sole proprietor1 Yes
Identifiers
  • GA License #: 037913
  • UT License #: 8263858-1205
  • GA Medicaid: 00570996C
  • GA Medicaid: 00570996F
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for TIMOTHY J SULLIVAN III, MD

There are currently no reviews for TIMOTHY J SULLIVAN III, MD


NPIdb - Home
v2.201