Smith, Sullivan K

Smith, Sullivan K is an individual health care provider with primary practice located at 1 Medical Center Blvd , Cookeville TN 38501-4294. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Smith, Sullivan K can be contacted via phone (931) 783-2334.

Contact Information

Primary practice address
1 Medical Center Blvd Cookeville TN 38501-4294
Fax: (931) 783-2253
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 18081 Tennessee

Profile Details

NPI number 1356346605
LBN Legal business name Smith, Sullivan K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2005
Last updated Mar 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356346605 NPPES
Tennessee MEDICAID 3100062

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