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Jonathon C. Sullum, MD
Diagnostic Radiology Physician in Scranton, Pennsylvania
NPI 1225041536

Jonathon C. Sullum is a Diagnostic Radiology Physician based in Scranton, PA and is specialized in Diagnostic Radiology. Jonathon C. Sullum practices in Scranton, PA and has the professional credentials of MD. The NPI Number for Jonathon C. Sullum is 1225041536 and holds a License No. MD020198E (Pennsylvania).

The current practice location address for Jonathon C. Sullum is 2601 Stafford Avenue, Scranton, PA and can be reached out via phone at 570-346-6633.

Location: 2601 Stafford Avenue, Scranton, PA, 18505-0305
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1225041536
Provider Name
Jonathon C. Sullum
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
2601 Stafford Avenue, Scranton, PA, 18505-0305
Phone Number
570-346-6633
Fax Number
Provider Enumeration Date
08/15/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000083999 01 PA THREE RIVERS
300020246 01 PA RAILROAD MEDICARE
0004210397 01 PA 0004210397
0006585310012 05 PA
C31604 01 PA BLUE CROSS
141629 01 PA HIGHMARK BLUE SHIELD
20007413 01 PA AMERIHEALTH MERCY
10624 1686 01 PA GEISINGER HEALTH PLAN
institution
Provider Business Practice Location Address Details
Address
2601 Stafford Avenue
City
Scranton
State
Pennsylvania
Zip
18505-0305
Phone Number
570-346-6633
Fax Number
person
Provider Business Mailing Address Details
Address
2601 Stafford Avenue
City
Scranton
State
Pennsylvania
Zip
18505-0305
Phone Number
570-346-6633
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
MD020198E (Pennsylvania)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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