Sullivan, Jerry J.

Sullivan, Jerry J. is an individual health care provider with primary practice located at 6501 Loisdale Ct , Springfield VA 22150-1826. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Sullivan, Jerry J. can be contacted via phone (703) 922-1000.

Contact Information

Primary practice address
6501 Loisdale Ct Springfield VA 22150-1826
Phone: (703) 922-1000
Fax: (703) 922-1039
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD00017070 Washington
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101243402 Virginia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X D0071387 Maryland
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD039385 District of Columbia

Profile Details

NPI number 1306998406
LBN Legal business name Sullivan, Jerry J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2007
Last updated Nov 22nd, 2011 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306998406 NPPES
Washington MEDICAID 8103087

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