DR. Kelly Ingrid Sullivan, MD

NPI #1043492291 in College Station, Texas

Provider Information

NPI Number: 1043492291
Entity Type: Individual
Name: DR. Kelly Ingrid Sullivan, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pediatrics
Credential: MD
Enumeration Date: Nov 29, 2007
Last Updated: May 21, 2010

Practice Location

Address: 1602 ROCK PRAIRIE RD
Address 2: SUITE 340
City: College Station
State: Texas
ZIP Code: 77845-8306
Phone: (979) 696-4440

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Pediatrics	208000000X	Primary

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