Sullivan, John Robert

Sullivan, John Robert is an individual health care provider with primary practice located at 1000 W Moreno St , Pensacola FL 32501-2316. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is his primary health care specialty. Sullivan, John Robert can be contacted via phone (850) 469-7406.

Contact Information

Primary practice address
1000 W Moreno St Pensacola FL 32501-2316
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X ME89561 Florida
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207RH0002X ME89561 Florida

Profile Details

NPI number 1730180456
LBN Legal business name Sullivan, John Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2005
Last updated Apr 29th, 2021 - about 3 years ago

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 1730180456 NPPES
Alabama MEDICAID 009934587
Alabama MEDICAID 274463500
Alabama MEDICAID 1495727
Alabama Other 59183344
Alabama Other 7161237
Alabama Other P00293340
Alabama Other 30178

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