| Doctor Name: | JOHN M SULLIVAN |
| NPI Number: | 1336132117 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | K5708 |
| Business Practice Address: | 802 W Lampasas St Ennis, TX - 751194500 |
| Business Phone Number: | 9728784700 |
| Business Fax Number: | 9728782238 |
| Mailing Address: | 802 W Lampasas St, ENNIS |
| State: | TX |
| Postal Code: | 751194500 |
| Phone Number: | 9728784700 |
| Fax Number: | 9728782238 |
| NPI Enumeration Date: | 08/26/2005 |
| NPI Last Update Date: | 01/13/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0129X |
| License Number: | K5708 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Vascular Surgery |
| Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |