person
John A. Sullivan, MD
Diagnostic Radiology Physician in Jackson, Wyoming
NPI 1013985134

John A. Sullivan is a Diagnostic Radiology Physician based in Springfield, WY and is specialized in Diagnostic Radiology. John A. Sullivan practices in Jackson, WY and has the professional credentials of MD. The NPI Number for John A. Sullivan is 1013985134 and holds a License No. R6F03 (Wyoming).

The current practice location address for John A. Sullivan is 7330 Ryegrass Road, Jackson, WY and can be reached out via phone at 307-733-9105.

Location: 7330 Ryegrass Road, Jackson, WY, 65804-6530
person
Provider Profile Details
NPI Number
1013985134
Provider Name
John A. Sullivan
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
7330 Ryegrass Road, Jackson, WY, 65804-6530
Phone Number
307-733-9105
Fax Number
Provider Enumeration Date
03/14/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1256 01 MO BLUE
202340501 05 MO
110826001 05 AR
300034332 01 MO RRR MEDICARE
institution
Provider Business Practice Location Address Details
Address
7330 Ryegrass Road
City
State
Zip
83001
Phone Number
307-733-9105
Fax Number
person
Provider Business Mailing Address Details
Address
7330 Ryegrass Road
City
State
Zip
83001
Phone Number
307-733-9105
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
License No.
R6F03 (Missouri)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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