DR. TIMOTHY JOHN SULLIVAN III (NPI# 1023012911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023012911 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY JOHN SULLIVAN III |
| Credential | M.D. |
| Practice Address |
4403 Harrison Blvd. Ste 4640 Ogden UT 84403-3304 |
| Practice Telephone | 8013874850 |
| Practice Fax Number | 8013874855 |
| Mailing Telephone | 8013874850 |
| Mailing Fax Number | 8013874855 |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2015-06-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
8263858-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
037913 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00570996F | 05 | |
| GA | 00570996C | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063024792 | Timothy Sullivan | Specialist/Technologist | 601 E Elm St Apt 1203, Troy, AL 36081-3498 | 2020-08-24 |
| 1215585112 | Timothy Sullivan II | Massage Therapist | 318 E Maiden St, Washington, PA 15301-5108 | 2019-09-04 |
| 1972954675 | Timothy Sullivan | Technician/Technologist | 38 Thatcher St, Rumford, RI 02916-2714 | 2016-06-24 |
| 1982019840 | Timothy Paul Sullivan | Chiropractor | 17000 E Us Highway 40 Ste 7, Independence, MO 64055-5394 | 2014-06-30 |
| 1306110176 | Timothy Coleman Sullivan | Behavioral Analyst | 7291 Garden Grove Blvd, Suite F, Garden Grove, CA 92841-4211 | 2012-02-26 |
| 1235452343 | Timothy Sullivan | Pharmacist | 336 Route 202, Somers, NY 10589-3220 | 2010-03-03 |
| 1619152915 | Timothy Mark Sullivan | Physician Assistant | 9951 E El Moro Ave, Mesa, AZ 85208-5869 | 2008-01-04 |
| 1396819215 | Timothy P Sullivan | Dentist | 370 W Terra Cotta Ave, Crystal Lake, IL 60014-3512 | 2006-11-20 |
| 1154408011 | Timothy Patrick Sullivan | Otolaryngology | 19 N Rivers Edge Dr, Little Silver, NJ 07739-1710 | 2006-10-31 |
| 1881786226 | Timothy Joseph Sullivan | Pediatrics | 92 New London Tpke, Norwich, CT 06360 | 2006-09-29 |
| Street Address |
4403 HARRISON BLVD. STE 4640 |
| City | OGDEN |
| State | UT |
| Zip Code | 84403-3304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437416500 | Brice J. Williams, M.d., P.C. | Ophthalmology | 4403 Harrison Blvd., Ste-3600, Ogden, UT 84403-3285 | 2012-04-13 |
| 1154574390 | Brice Jason Williams | Ophthalmology | 4403 Harrison Blvd., Suite 3600, Ogden, UT 84403-3285 | 2008-10-31 |
| 1669507984 | Bryson S. Smith | Specialist | 4403 Harrison Blvd., Suite 1815, Ogden, UT 84403-3339 | 2007-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235744632 | Megan Louise Larkins | Specialist/Technologist | 4000 Brinker Ave. The Apartments., Apartment 15, Ogden, UT 84403 | 2020-09-11 |
| 1154959062 | Joshua Clifford Hansen | Student in an Organized Health Care Education/Training Program | 4403 Harrison Boulevard, Ste A700, Ogden, UT 84403 | 2020-03-28 |
| 1346895935 | Positional Release Therapy Institute LLC | Specialist/Technologist | 1702 E. 5600 S., Ogden, UT 84403 | 2019-08-09 |
| 1841842077 | Braken Wooden | Chiropractor | 1893 Skyline Dr., Suite 204, South Ogden, UT 84403 | 2019-07-09 |
| 1023670569 | Wasatch Advanced Dental Care LLC | Dentist | 3590 Harrison Blvd Suite #1, Ogden, UT 84403 | 2019-07-05 |
| 1194237636 | Marci Niemeyer | Physician Assistant | 5929 Fashion Point Dr Ste 101, South Ogden, UT 84403 | 2017-10-24 |
| 1578081949 | Stephanie Jensen | Specialist/Technologist | 1473 36th Street, Ogden, UT 84403 | 2017-09-06 |
| 1891213385 | Forrest Sutherland | Specialist/Technologist | 1075 E 41st St., Ogden, UT 84403 | 2017-09-05 |
| 1184159022 | Nicole Lee Van Tassell | In Home Supportive Care | 1496 East 5600 South, Unit 6, Ogden, UT 84403 | 2017-04-28 |
| 1265889166 | Modern Dental Professionals Ut, PC | Dentist | 5974 S. Fashion Pointe Drive, Suite 210, South Ogden, UT 84403 | 2016-05-20 |
| Find all providers in zip 84403 | ||||
| Taxonomy Code | 207KA0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| Specialization | Allergy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548513799 | Timothy Sullivan, Md PC | Allergy & Immunology | 4403 Harrison Blvd, Ste# 4640, Ogden, UT 84403-3271 | 2012-10-24 |
| 1780716563 | Vicki J Lyons Md PC | Allergy & Immunology | 4403 Harrison Blvd, Suite 4640, Ogden, UT 84403-3271 | 2007-03-09 |
| 1326013574 | Vicki J Lyons | Allergy & Immunology | 4403 Harrison Blvd, Suite 4640, Ogden, UT 84403-3271 | 2006-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306027842 | Aaron Kobernick | Allergy & Immunology | 50 N Medical Dr # 28, Salt Lake City, UT 84132-2632 | 2007-11-26 |
| 1104356013 | Tanner Memorial Clinic | Allergy & Immunology | 5296 S Commerce Dr, Murray, UT 84107-4767 | 2017-06-13 |
| 1144648213 | Gourley Allergy & Asthma PC | Allergy & Immunology | 6065 S Fashion Blvd, Ste 255, Murray, UT 84107-7381 | 2014-04-04 |
| 1659616241 | Rocky Mountain Allergy Asthma and Immunology, LLC | Allergy & Immunology | 1660 W Antelope Dr, Suite 225, Layton, UT 84041-1156 | 2012-12-07 |
| 1902080237 | Robert Silge | Allergy & Immunology | 2000 S 900 E, Salt Lake City, UT 84105-3208 | 2007-12-21 |
| 1467576322 | Scott D Dickson | Allergy & Immunology | 1350 N 500 E, Logan, UT 84341-2400 | 2007-03-18 |
| 1346324761 | Douglas Harry Jones | Allergy & Immunology | 2121 N 1700 W, Layton, UT 84041-8803 | 2006-10-24 |
| 1942318530 | Marcia L Muggelberg | Allergy & Immunology | 9500 S 1300 E, Sandy, UT 84094-3763 | 2006-08-25 |
| 1265487300 | Jan B Bernhisel-broadbent | Allergy & Immunology | 2000 S 900 E, Salt Lake City, UT 84105-3208 | 2006-05-24 |
| 1447239355 | Tanner Memorial Clinic | Allergy & Immunology | 2121 N 1700 W, Layton, UT 84041-8803 | 2006-01-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.