Mark S. Sullivan, M.D., PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

OKC8667 Issued in OK

Legal business name

MARK S. SULLIVAN, M.D., PLLC

Practice address

3366 NW Expressway St
Suite 720
Oklahoma City, OK 73112-4462

Phone

(405) 947-0676

Fax

(405) 945-4876

NPI assigned

May 23, 2007

Organization subpart

No

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

Authorized official

Name

Mark Stover Sullivan, M.D.

Title

President

Phone

(405) 947-0676

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1821208182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3366 NW EXPRESSWAY",
            "address_2": "SUITE 720",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124462",
            "telephone_number": "405-947-0676",
            "fax_number": "405-945-4876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 NW EXPRESSWAY ST",
            "address_2": "SUITE 720",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124462",
            "telephone_number": "405-947-0676",
            "fax_number": "405-945-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK S. SULLIVAN, M.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "STOVER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-947-0676",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OK",
            "license": "OKC8667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Janna Kaylene Markham, PT
• Lisa Markham, RDH

• Specialist in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.