MEDICARE: KELSEA WRIGHT O'SULLIVAN MD

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	207L00000X	Anesthesiology Physician	52729	AL

General Provider Information

NPI Number	:	1184243842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEA WRIGHT O'SULLIVAN MD

Provider Business Mailing Address
First Line	:	3104 BLUE LAKE DR STE 110
Second Line	:
City	:	VESTAVIA
State	:	AL
Zip	:	35243-2372
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3719 DAUPHIN ST
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36608-1753
Country	:	US
Telephone Number	:	251-344-9630
Fax Number	:

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

Provider Enumeration Date	:	04/13/2020
Last Update Date	:	02/10/2026

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