MICHAEL J SULLIVAN (NPI# 1710087119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710087119 |
| Entity Type | Individual |
| Full Name | MICHAEL J SULLIVAN |
| Credential | M.D. |
| Practice Address |
400 Fairview Suite 19 Ponca City OK 74602 |
| Practice Telephone | 5807652496 |
| Practice Fax Number | 5807620896 |
| Mailing Telephone | 5807652496 |
| Mailing Fax Number | 5807620896 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 10274 | OK | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366918617 | Michael David Sullivan | Social Worker | 403 1/2 Hector St, Ithaca, NY 14850-2025 | 2018-10-15 |
| 1376923292 | Michael Sullivan | Student in an Organized Health Care Education/Training Program | Walter Reed 8901 Rockville Pike, Bethesda, MD 20889-0001 | 2015-06-05 |
| 1881074896 | Michael Gregory Sullivan | Intermediate Care Facility, Mentally Retarded | 30 Hobomack Rd, Quincy, MA 02169-2508 | 2015-06-04 |
| 1104215136 | Michael Sullivan | Perfusionist | 137 Founders Way Ct, Cape Girardeau, MO 63701-9442 | 2015-01-14 |
| 1689927915 | Michael Robert Sullivan | Pharmacist | 41 Buena Vista St, Stamford, CT 06907-2402 | 2012-10-24 |
| 1154672038 | Michael James Sullivan | Dentist | 1882 Hard Rd, Columbus, OH 43235-1996 | 2012-10-02 |
| 1063791747 | Michael Gruer Sullivan | Counselor | 2024 N. Crystal Lake Dr., Suite 200 Room 205, Lakeland, FL 33801-6015 | 2011-08-11 |
| 1457647083 | Michael Patrick Sullivan | Dentist | 1008 G Sreet, Geneva, NE 68361 | 2011-06-22 |
| 1841528585 | Michael Andrew Sullivan | Counselor | 974 73rd St Ste 9, Windsor Heights, IA 50324-1026 | 2009-11-18 |
| 1508191388 | Michael Joseph Sullivan | Audiologist | 6644 Penn Ave S, Richfield, MN 55423-2026 | 2009-10-12 |
| Street Address |
400 FAIRVIEW SUITE 19 |
| City | PONCA CITY |
| State | OK |
| Zip Code | 74602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295790459 | Shrikrishna V Vaidya | Psychiatry & Neurology | 400 Fairview, St 10, Ponca City, OK 74601 | 2006-04-19 |
| 1780960468 | Ponca Sleep Interpretors LLC | Specialist | 400 Fairview, Suite10, Ponca City, OK 74601 | 2011-10-26 |
| 1023295839 | Gary A Dorman | Eyewear Supplier (Equipment, not the service) | 400 Fairview, Suite 21, Ponca City, OK 74601-1922 | 2008-01-23 |
| 1265531610 | Phillip Joseph Knight | Family Medicine | 400 Fairview, Suite 15, Ponca City, OK 74601 | 2006-09-22 |
| 1356399927 | Alzira F Vaidya | Psychiatry & Neurology | 400 Fairview, St 10, Ponca City, OK 74601 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720188105 | Stephen R Snyder | Nurse Anesthetist, Certified Registered | 1900 N 14th, Ponca City, OK 74602 | 2006-09-25 |
| 1609224484 | Warren Rivers | Clinic/Center | 602 W. Grand Avenue, Bridgeway Inc, Ponca City, OK 74602-0883 | 2016-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972537 | Tamra Lynn Cunningham | Peer Specialist | 764 Sherwin Ave, Ponca City, OK 74604-6112 | 2020-11-05 |
| 1407456114 | Nicole Roberts | Case Manager/Care Coordinator | 2505 E Hartford Ave Apt 10, Ponca City, OK 74604-3009 | 2020-10-30 |
| 1376143883 | Tina Marie Lopez | Peer Specialist | 933 N Oak St, Ponca City, OK 74601-3218 | 2020-10-26 |
| 1679172951 | Children S Therapy Zone LLC | Occupational Therapy Assistant | 220 Village Cir, Ponca City, OK 74601-4021 | 2020-10-19 |
| 1952911018 | Amy Stangeland | Nurse Practitioner | 3001 Larchmont Ave, Ponca City, OK 74604-4432 | 2020-08-04 |
| 1447868849 | Cammie Ladawn Wyckoff | Registered Nurse | 1500 Cookson Dr, Ponca City, OK 74604-4109 | 2020-07-21 |
| 1952929515 | Tasha Shea Smith | Registered Nurse | 2225 N. Union, Ponca City, OK 74601-1536 | 2020-07-10 |
| 1730705229 | Jenna Specht | Physician Assistant | 2501 N 14th St, Ponca City, OK 74601-1734 | 2020-06-19 |
| 1245867258 | Triad Health Systems LLC | Family Medicine | 2703 N 14th St, Ponca City, OK 74601 | 2020-03-27 |
| 1891328274 | Ponca City Dental Group Pllc | Dentist | 1216 E Hartford Ave Ste 1a, Ponca City, OK 74601-2059 | 2020-02-13 |
| Find all providers in PONCA CITY | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447498225 | Vijay S Vaidya | Internal Medicine | 2703 Mockingbird Dr, Ponca City, OK 74604-3239 | 2009-02-02 |
| 1427034792 | John W Holden | Internal Medicine | 427 Fairview Ave, Ponca City, OK 74601-1923 | 2005-12-19 |
| 1396737888 | Melinda Rother Allen | Internal Medicine | 100 Elmwood Ave, Ponca City, OK 74601-3406 | 2005-08-19 |
| 1881954501 | Jeremy Theisen | Internal Medicine | 1900 N 14th St, Ponca City, OK 74601-2035 | 2012-05-29 |
| 1235438219 | John W. Holden, M.d., P.C. | Internal Medicine | 427 Fairview Ave, Ponca City, OK 74601-1923 | 2011-03-16 |
| 1134294770 | Bruce Baugher D.o., PC | Internal Medicine | 1908 N 14th St, Suite 207, Ponca City, OK 74601-2014 | 2006-11-21 |
| 1942208855 | Patrick Wallace Gray | Internal Medicine | 400 Fairview Ave, Suite 17, Ponca City, OK 74601-1910 | 2005-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083222038 | Miloni Mukesh Parmar | Internal Medicine | 800 Stanton L Young Blvd Aat 6300, Oklahoma City, OK 73104-5018 | 2020-07-16 |
| 1073133880 | Dr Brandon Bailey Do Pllc | Internal Medicine | 3621 S Elder Blvd, Broken Arrow, OK 74011-1755 | 2020-04-22 |
| 1295366540 | Rebecca Wright Do Pllc | Internal Medicine | 18405 S 4190 Rd, Claremore, OK 74017-5366 | 2020-01-27 |
| 1376181479 | Meraki Wellness Group, LLC | Internal Medicine | 1211 N Shartel Ave Ste 802, Oklahoma City, OK 73103-2425 | 2019-12-19 |
| 1497319297 | Sara Hart | Internal Medicine | 420 W. Stone Wood Drive, Broken Arrow, OK 74012 | 2019-04-26 |
| 1033688270 | Results Medical Aesthetics LLC | Internal Medicine | 8014 S. 101st E. Ave., Suite 200, Tulsa, OK 74133-4580 | 2018-11-16 |
| 1578031571 | Oklahoma Wellness Group LLC | Internal Medicine | 14101 North Esatern Avenue Suite B, Edmond, OK 73013 | 2018-11-07 |
| 1770068827 | Absolute Health Medical Partners LLC | Internal Medicine | 1305 Nw 187th St, Edmond, OK 73012-6206 | 2018-09-25 |
| 1447746417 | Nimrah Bader | Internal Medicine | 800 Stanton L. Young Blvd., Aat 6300, Oklahoma City, OK 73104 | 2018-07-02 |
| 1407349442 | Sarah Monther Nimri | Internal Medicine | 1200 Childrens Ave Ste 14046, Oklahoma City, OK 73104-4637 | 2018-06-13 |
| Find all providers with the same taxonomy | ||||
| City | PONCA CITY |
| Zip Code | 74602 |
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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.