Henry Paul Sullivant Jr., MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

14964 Issued in TN

Practice address

6215 Humphreys Blvd
Suite 500
Memphis, TN 38120-2367

Phone

(901) 682-0630

Fax

(901) 682-0635

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407879471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6215 HUMPHREYS BLVD",
            "address_2": "SUITE 500",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202367",
            "telephone_number": "901-682-0630",
            "fax_number": "901-682-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6215 HUMPHREYS BLVD",
            "address_2": "SUITE 500",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202367",
            "telephone_number": "901-682-0630",
            "fax_number": "901-682-0635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVANT",
        "first_name": "HENRY",
        "middle_name": "PAUL",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "14964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan Dale Jackson Sullivan, M.D.
• Patrick Scott Sullivan, MD
• Sarah Hazlegrove Sullivan, MS, RD, LDN
• William Micaiah Sullivan, R.N.
• Willie Floyd Sullivan Jr., M.S.
• Ibrahim A Sultan-Ali, MD
• Amer Adnan Sultan, MD
• Otis Sumlin, LCSW
• Summer Health & Wellness PLLC (Summer Medical)
• Mary Summers

• Specialist in Memphis, TN
• Providers in Memphis, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.