<Unavail>

LBN: Matthew R Sullivan Od
<Unavail> is an health care organization with primary practice located at 980 Willow Creek Road Suite 202, Prescott AZ 86301. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Matthew R Sullivan Od can be contacted via phone (928) 778-3937, or through Sullivan, Matthew Ryan via phone (928) 778-3937.

Contact Information

Primary practice address
980 Willow Creek Road Suite 202 Prescott AZ 86301
Phone: (928) 778-3937
Fax: (928) 778-3939
Website:
Map and Directions
Authorized official contact:
Name: Sullivan, Matthew Ryan Doctor of Optometry (OD)
Phone: (928) 778-3937

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1102 Arizona

Profile Details

NPI number 1285813360
LBN Legal business name Matthew R Sullivan Od
DBA Doing business as <Unavail>
Authorized official Sullivan, Matthew Ryan Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 25th, 2007
Last updated May 19th, 2026 - about 5 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285813360 NPPES
Arizona Other 4244670001 DMERC
Arizona MEDICAID 578966 DMERC

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