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:
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Health care specialties

SpecialtyCodeLicense #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 17 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 1417956400 NPPES
Tennessee MEDICAID 3882277

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