Sullivan, Timothy James
Sullivan, Timothy James is an individual health care provider with primary practice located at 2300 Pavilion Dr , Kingsport TN 37660-4622. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Sullivan, Timothy James can be contacted via phone (423) 587-5571.Contact Information
Primary practice address
2300 Pavilion Dr
Kingsport TN 37660-4622
Phone: (423) 587-5571
Fax: (423) 587-5237
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | MD18502 | Tennessee |
Profile Details
NPI number | 1417956400 |
---|---|
LBN Legal business name | Sullivan, Timothy James |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 20th, 2005 |
Last updated | Jan 13th, 2009 - about 15 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1417956400 | NPPES |
Tennessee | MEDICAID | 3882277 |
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