Sullivan, Jon M.

Sullivan, Jon M. is an individual health care provider with primary practice located at 100 Jackson Pike , Gallipolis OH 45631-1560. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Sullivan, Jon M. can be contacted via phone (740) 446-5371.

Contact Information

Primary practice address
100 Jackson Pike Gallipolis OH 45631-1560
Phone: (740) 446-5371
Fax: (740) 446-5711
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 16987 West Virginia
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35-05-4754 Ohio

Profile Details

NPI number 1053341370
LBN Legal business name Sullivan, Jon M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Dec 29th, 2020 - about 5 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 1053341370 NPPES
Ohio Other 000000181879 UNISON MEDICAID #
Ohio Other 001714064 UNISON MEDICAID #
Ohio Other 0882719 UNISON MEDICAID #
Ohio Other 000000006810 UNISON MEDICAID #
Ohio Other 370002760 UNISON MEDICAID #
Ohio Other 000000007592 UNISON MEDICAID #
Ohio MEDICAID 0107833000 UNISON MEDICAID #
Ohio MEDICAID 0882719 UNISON MEDICAID #
Ohio Other 310917085065 UNISON MEDICAID #

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