Sullivan, Mark T

Sullivan, Mark T is an individual health care provider with primary practice located at 2900 12Th Ave N Suite 140W, Billings MT 59101-7506. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Sullivan, Mark T can be contacted via phone (406) 238-6540.

Contact Information

Primary practice address
2900 12Th Ave N Suite 140W Billings MT 59101-7506
Phone: (406) 238-6540
Fax: (406) 238-6599
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 205 Montana

Profile Details

NPI number 1952393514
LBN Legal business name Sullivan, Mark T
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Apr 29th, 2008 - about 16 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 1952393514 NPPES
Montana Other 970010277 RR MEDICARE
Montana MEDICAID 435438 RR MEDICARE
Montana Other 000900883 RR MEDICARE
Montana MEDICAID 119184500 RR MEDICARE

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