| Kevin Sullivan, | |
|
541 Historic Highway 441, Demorest, GA 30535 | |
| (706) 839-4000 | |
| Not Available |
| Full Name | Kevin Sullivan |
|---|---|
| Gender | Male |
| Speciality | Hospitalist |
| Experience | 11 Years |
| Location | 541 Historic Highway 441, Demorest, Georgia |
| 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 |
|---|---|---|---|
| 1346656170 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301106158 (Michigan) | Secondary |
| 208M00000X | Hospitalist | 82648 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Piedmont Newnan Hospital, Inc | Newnan, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Piedmont Hospitalist Physicians Llc | 1951299163 | 396 |
| Entity Name | Piedmont Hospitalist Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548219660 PECOS PAC ID: 1951299163 Enrollment ID: O20040309000820 |
| Entity Name | Northeast Georgia Physicians Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891745212 PECOS PAC ID: 6901898386 Enrollment ID: O20040402001277 |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Sullivan, Po Box 742616, Atlanta, GA 30374-2616 Ph: (770) 219-8420 | Kevin Sullivan, 541 Historic Highway 441, Demorest, GA 30535 Ph: (706) 839-4000 |
Dr. David Allen Bray, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 541 Historic Highway 441 North, Demorest, GA 30535 Phone: 706-839-4000 | |
Adam E Traill, DO Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 541 441 Historic Hwy N, Demorest, GA 30535 Phone: 706-839-4000 | |
Edwin Enrique Villarreal, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 541 Historic Hwy 441-n, Demorest, GA 30535 Phone: 770-219-7078 Fax: 770-219-7365 |