Fred M Sullivan is a Pediatrics in Shreveport, Louisiana. Fred M Sullivan practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for Fred M Sullivan is 1841396611. The last update date is 2012-05-15.
Fred M Sullivan's current location address is 1512 W Kirby Pl, Shreveport, Louisiana. You can contact this provider via phone number 3186757636. The mailing address for Fred M Sullivan is 1512 W Kirby Pl, Shreveport, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Fred M Sullivan |
|---|---|
| Address | 1512 W Kirby Pl, Shreveport, Louisiana |
| Phone Number | 3186757636 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1841396611 |
|---|---|
| Provider Enumeration Date | 2006-09-16 |
| Last Updated Date | 2012-05-15 |
Provider Mailing Address Detail
| Address | 1512 W Kirby Pl |
|---|---|
| City | Shreveport |
| State | Louisiana (LA) |
| Post Code | 711033822 |
| Phone Number | 3186757636 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 208000000X |
| Licence No | 16881 |
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Definition: A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1345261 | LA | -- | |
| 5M257F600 | LA | MEDICARE - PTAN |
Post Comment/ Review Below
Could you please provide the complete street address where Fred M Sullivan is physically located?
The Fred M Sullivan is physically situated at the following address: 1512 W Kirby Pl, Shreveport, LA, 711033822.
What is the Fred M Sullivan's area of specialization and corresponding taxonomy classification?
The Fred M Sullivan's specialty field is Pediatrics, and it falls under the taxonomy code 208000000X, which categorizes healthcare providers based on their specialties.
When did the Fred M Sullivan receive its 1841396611?
The Fred M Sullivan was issued its 1841396611 on 2006-09-16, which is the date when the organization was assigned this unique identifier.
As of what date were the Fred M Sullivan's details last updated?
The information pertaining to the Fred M Sullivan, including its address, specialty, and other details, was most recently updated on 2012-05-15.
As of what date were the details related to Fred M Sullivan most recently updated or revised?
The information pertaining to Fred M Sullivan, including its address, specialty, and other relevant details, was last updated or revised on 2012-05-15.
NPI Number: 1215930425
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