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NPI Code Detail

MEDICARE: RYAN ALEXANDER SULLIVAN DO

MEDICARE:   RYAN ALEXANDER SULLIVAN  DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207R00000XInternal Medicine Physician6776TN

General Provider Information

NPI Number : 1376246637
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN ALEXANDER SULLIVAN DO
Provider Business Mailing Address
First Line : 4220 HARDING PIKE
Second Line :
City : NASHVILLE
State : TN
Zip : 37205-2005
Country : US
Telephone Number : 615-222-2111
Fax Number :
Provider Business Practice Location Address
First Line : UNIVERSITY OF TENNESSEE 920 MADISON AVE SUITE 447
Second Line :
City : MEMPHIS
State : TN
Zip : 38163-0001
Country : US
Telephone Number : 901-448-5814
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2023
Last Update Date : 05/30/2026

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Directions to “ RYAN ALEXANDER SULLIVAN DO” Practice Location

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