Sullivan, Jeremy Tyson

Sullivan, Jeremy Tyson is an sole proprietor health care provider with primary practice located at 10601 Winterwood , Carmel IN 46032-8258. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Sullivan, Jeremy Tyson can be contacted via phone (615) 478-3720.

Contact Information

Primary practice address
10601 Winterwood Carmel IN 46032-8258
Phone: (615) 478-3720
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 35131 Tennessee
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 01066525A Indiana

Profile Details

NPI number 1053379644
LBN Legal business name Sullivan, Jeremy Tyson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 3rd, 2006
Last updated Mar 7th, 2023 - 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 1053379644 NPPES
Tennessee MEDICAID 3865060

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