IndividualActive
John Sullivan, M.D.
NPI 1013985134 · Diagnostic Radiology Physician · Jackson, WY
Provider details
- NPI number
- 1013985134
- Entity type
- Individual
- Primary specialty
- Diagnostic Radiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- R6F03 (MO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
7330 Ryegrass Road
Jackson, WY 83001
Phone: (307) 733-9105
Approximate (ZIP-level) locationGet directions
Mailing address
1550 E Republic Rd
Springfield, MO 65804-6530
Registry dates
- Enumerated
- 2006-03-14
- Last updated
- 2009-09-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.