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General NPI Number Information
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NPI Number | 1083569966
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Entity Type | Organization
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Legal Business Name | LORI A SULLIVAN MD LLC
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Dates
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Enumeration Date | 03/04/2026
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 487 W MAIN ST STE B
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City | WEST JEFFERSON
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State | OH
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Zip | 43162-1178
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Country | US
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Telephone | 614-454-7559
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Fax | 614-454-2989
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Provider Business Mailing Address
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Address Line | 487 W MAIN ST STE B
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City | WEST JEFFERSON
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State | OH
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Zip | 43162-1178
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Country | US
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Telephone | 614-454-7559
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Fax | 614-454-2989
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. LORI SULLIVAN
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Credential | MD
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Telephone | 614-454-7559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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