Healthcare Provider Details

I. General information

NPI: 1730179607
Provider Name (Legal Business Name): JAMES D SULLIVAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 WASHINGTON ST
TAUNTON MA
02780-2465
US

IV. Provider business mailing address

PO BOX 609
CATAUMET MA
02534-0609
US

V. Phone/Fax

Practice location:
  • Phone: 508-828-7100
  • Fax:
Mailing address:
  • Phone: 508-254-8424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number72262
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD09038
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number72262
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: