Sullivan Eye Center, S.c.

NPI #1104919869 in Appleton, Wisconsin

Provider Information

NPI Number: 1104919869
Entity Type: Organization
Organization Name: Sullivan Eye Center, S.c.
Primary Specialty: Ophthalmology
Enumeration Date: Oct 2, 2006
Last Updated: Sep 3, 2008

Practice Location

Address: 1195 N CASALOMA DR
City: Appleton
State: Wisconsin
ZIP Code: 54913-9295
Phone: (920) 734-0400

Authorized Official

Name: ROBERT D. SULLIVAN, M.D.
Title: PRESIDENT
Phone: (920) 734-0400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X
Ophthalmology	207W00000X	Primary

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