| Cary Patrick Sullivan, DO | |
|
128 W Main, Vian, OK 74962-0446 | |
| (918) 773-5228 | |
| (918) 289-2678 |
| Full Name | Cary Patrick Sullivan |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 46 Years |
| Location | 128 W Main, Vian, Oklahoma |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497701130 | NPI | - | NPPES |
| 731153208003 | Other | OK | BLUE CROSS BLUE SHIELD |
| 100254810E | Medicaid | OK | |
| 100254810G | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2148 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Professional Home Health | Sallisaw, OK | Home health agency |
| Cima Hospice Of Sallisaw | Sallisaw, OK | Hospice |
| Sequoyah County-city Of Sallisaw Hospital Authorit | Sallisaw, OK | Hospital |
| Baptist Health - Fort Smith | Fort smith, AR | Hospital |
| Mercy Hospital Fort Smith | Fort smith, AR | Hospital |
| Saint Francis Hospital Muskogee | Muskogee, OK | Hospital |
| Northeastern Health System | Tahlequah, OK | Hospital |
| Vian Nursing & Rehab, Llc | Vian, OK | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Triton Health Pllc | 1951623214 | 2 |
| Triton Health Elder Care Llc | 4082154927 | 2 |
| Entity Name | Triton Health Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275945974 PECOS PAC ID: 1951623214 Enrollment ID: O20141124001108 |
| Entity Name | Triton Health Elder Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619710787 PECOS PAC ID: 4082154927 Enrollment ID: O20240906001607 |
| Mailing Address | Practice Location Address |
|---|---|
| Cary Patrick Sullivan, DO Po Box 446, Vian, OK 74962-0446 Ph: (918) 773-5228 | Cary Patrick Sullivan, DO 128 W Main, Vian, OK 74962-0446 Ph: (918) 773-5228 |