DR. BETH ANN SULLIVAN DO NPI 1669476388

NPI Information

NPI: 1669476388
Provider Name: DR. BETH ANN SULLIVAN, DO
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
1960 RIVERSIDE PKWY
STE 106
LAWRENCEVILLE, GA
ZIP 30043
Phone: (678) 407-2222
Get Directions

DR. Beth Ann Sullivan, DO is a family medicine in Lawrenceville, GA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Beth Ann Sullivan, DO NPI is 1669476388. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1960 RIVERSIDE PKWY
STE 106
LAWRENCEVILLE, GA
ZIP 30043-945
Phone: (678) 407-2222

The enumeration date for this NPI number is 6/9/2005 and was last updated on 3/5/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		049106	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	54305	OTHER	GEORGIA	SOUTHCARE ID
2	08BBRCP	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA	MEDICARE PROVIDER #
3	10041812	MEDICAID	GEORGIA
4	903825	OTHER	GEORGIA	BCBSGA PROVIDER ID
5	85002412G	MEDICAID	GEORGIA
6	7393382	OTHER	GEORGIA	AETNA PROVIDER ID
7	327120	MEDICAID	GEORGIA
8	P00147319	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA	RAILROAD MEDICARE
9	G76399	MEDICARE UPIN
10	000888698D	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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