MEDICARE: JOHN PATRICK SULLIVAN M.D.

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
1	2085R0202X	Diagnostic Radiology Physician	39464	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952368557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN PATRICK SULLIVAN M.D.

Provider Business Mailing Address
First Line	:	1218 S BROADWAY
Second Line	:	SUITE 310
City	:	LEXINGTON
State	:	KY
Zip	:	40504-2759
Country	:	US
Telephone Number	:	859-219-0542
Fax Number	:	859-219-9433

Provider Business Practice Location Address
First Line	:	850 W BARAGA AVE
Second Line	:
City	:	MARQUETTE
State	:	MI
Zip	:	49855-4550
Country	:	US
Telephone Number	:	906-449-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	08/03/2022

Similar Medicare Providers

1124001771 — JEFFREY A FIERSTINE P.A.
Practice Location Address:

850 W BARAGA AVE STE 31
MARQUETTE, MI
49855-4550

Practice Phone: 906-449-3000
Practice Fax:

1922938448 — AVERY LIAM RASON CTRS
Practice Location Address:

850 W BARAGA AVE
MARQUETTE, MI
49855-4550

Practice Phone: 906-449-3000
Practice Fax:

1639485527 — KIMBERLEE M PARKS P.A.
Practice Location Address:

850 W BARAGA AVE STE 20
MARQUETTE, MI
49855-4550

Practice Phone: 906-449-3440
Practice Fax: 833-916-2326

1033869292 — RYAN JACOB MILLER
Practice Location Address:

850 W BARAGA AVE
MARQUETTE, MI
49855-4550

Practice Phone: 906-449-3560
Practice Fax:

1013919380 — DR. ROBERT JOHN CARROLL M.D.
Practice Location Address:

850 W BARAGA AVE
MARQUETTE, MI
49855-4550

Practice Phone: 906-449-3000
Practice Fax:

1982687026 — DANIEL DOMINGUES DE OLIVEIRA M.D.
Practice Location Address:

850 W BARAGA AVE STE 20
MARQUETTE, MI
49855-4550

Practice Phone: 906-449-3440
Practice Fax: 906-449-1952

Directions to “ JOHN PATRICK SULLIVAN M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.