TIMOTHY SULLIVAN, MD PC (NPI# 1548513799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548513799 |
| Entity Type | Organization |
| Organization Name | TIMOTHY SULLIVAN, MD PC |
| Practice Address |
4403 Harrison Blvd Ste# 4640 Ogden UT 84403-3271 |
| Practice Telephone | 8013874850 |
| Practice Fax Number | 8013874855 |
| Mailing Telephone | 8013874850 |
| Mailing Fax Number | 8013874855 |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2012-10-24 |
| Authorized Official Name | DR. TIMOTHY J SULLIVAN III (MEDICAL DOCTOR) |
| Authorized Official Telephone | 8013874850 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
8263858-1205 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
4403 HARRISON BLVD STE# 4640 |
| City | OGDEN |
| State | UT |
| Zip Code | 84403-3271 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518962794 | Fred George Seale Iv | Obstetrics & Gynecology | 4403 Harrison Blvd, Ste 4650, Ogden, UT 84403-3271 | 2005-06-15 |
| 1720502859 | Derek Smith | Physician Assistant | 4403 Harrison Blvd, Ogden, UT 84403-3271 | 2017-07-31 |
| 1245766393 | Jacob Saunders | Student in an Organized Health Care Education/Training Program | 4403 Harrison Blvd, Suite A-700, Ogden, UT 84403-3271 | 2017-05-11 |
| 1043746191 | Haleigh Emerson | Family Medicine | 4403 Harrison Blvd, Suite A700, Ogden, UT 84403-3271 | 2017-05-11 |
| 1457887507 | Madison Beatty | Student in an Organized Health Care Education/Training Program | 4403 Harrison Blvd, Suite A700, Ogden, UT 84403 | 2017-05-11 |
| 1669908711 | Spencer Ruben | Student in an Organized Health Care Education/Training Program | 4403 Harrison Blvd, Suite A700, Ogden, UT 84403-3271 | 2017-05-11 |
| 1376083147 | Linda Maria Jones | Nurse Practitioner | 4403 Harrison Blvd, Suite 3490, Ogden, UT 84403 | 2017-02-27 |
| 1114376431 | Jonas Legrand Peterson | Family Medicine | 4403 Harrison Blvd, Suite A-700, Ogden, UT 84403-3271 | 2016-06-07 |
| 1649629965 | Derek Paul Wille | Family Medicine | 4403 Harrison Blvd, Suite A-700, Ogden, UT 84403-3271 | 2016-06-07 |
| 1467838086 | Brandy Millward | Social Worker | 4403 Harrison Blvd, Suite 3630, Ogden, UT 84403-3271 | 2015-08-05 |
| Find all providers in the same location | ||||
| 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 |
|---|---|---|---|---|
| 1023012911 | Timothy John Sullivan IIi | Allergy & Immunology | 4403 Harrison Blvd., Ste 4640, Ogden, UT 84403-3304 | 2005-06-08 |
| 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 | ||||
Please comment or provide details below to improve the information on TIMOTHY SULLIVAN, MD PC.
| 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.