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NPI Code Detail

MEDICARE: JW SULLIVAN CONSULTANTS PLLC.

MEDICARE: JW SULLIVAN CONSULTANTS PLLC.
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
1207L00000XAnesthesiology Physician

General Provider Information

NPI Number : 1760908495
Entity Type Code : Organization
Provider Name (Legal Business Name) : JW SULLIVAN CONSULTANTS PLLC.
Provider Business Mailing Address
First Line : PO BOX 41
Second Line :
City : MUNCIE
State : IN
Zip : 47308-0041
Country : US
Telephone Number : 765-284-0493
Fax Number : 765-284-2434
Provider Business Practice Location Address
First Line : 1800 PARK PLACE AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76110-1302
Country : US
Telephone Number : 682-703-5600
Fax Number :
Authorized Official
Title or Position : OWNER/AUTH OFFICIAL
Name : AARON SHIRAZ
Credential : M.D.
Telephone Number : 682-582-7001
Provider Enumeration Date : 08/15/2017
Last Update Date : 01/25/2018

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Directions to “JW SULLIVAN CONSULTANTS PLLC. ” Practice Location

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