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Contact Information

SULLIVAN FAMILY PRACTICE, LLC
2229 MARY SHERMAN DR
SULLIVAN, IN47882-7633
 Phone: 812-268-3318
 Fax: 812-268-4017
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Rural Health

261QR1300X B4[14] Rural Health Clinic
Indicates primary specialty

NPI Profile & details for SULLIVAN FAMILY PRACTICE LLC · (Female)

NPI Number 1770502981
Status Active
Credentials
Entity Individual
Enumeration date 07/19/2006
Last updated 10/26/2009 - About 17 years ago
Sole proprietor 1 Not specified
Identifiers
  • IN License # 01036108
  • IN Medicaid 200015680A
  • IN Other 153868 RURAL HEALTH CLINIC
Hospital affiliation(s) Not Available
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.

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