| Sheila Kerri Sullivan, DO | |
|
123 Hospital Drive, Suite 1002, Watertown, WI 53098-3320 | |
| (920) 261-8225 | |
| (920) 261-5343 |
| Full Name | Sheila Kerri Sullivan |
|---|---|
| Gender | Female |
| Speciality | Ophthalmology |
| Experience | 16 Years |
| Location | 123 Hospital Drive, Watertown, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992023493 | NPI | - | NPPES |
| 1992023493 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207W00000X | Ophthalmology | 61084-21 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Watertown Memorial Hospital | Watertown, WI | Hospital |
| Fort Memorial Hospital | Fort atkinson, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Watertown Physician Practices Llc | 8022329408 | 45 |
| Entity Name | Watertown Physician Practices Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770964363 PECOS PAC ID: 8022329408 Enrollment ID: O20150626000114 |
| Mailing Address | Practice Location Address |
|---|---|
| Sheila Kerri Sullivan, DO 123 Hospital Drive, Suite 1002, Watertown, WI 53098-3320 Ph: (920) 261-8225 | Sheila Kerri Sullivan, DO 123 Hospital Drive, Suite 1002, Watertown, WI 53098-3320 Ph: (920) 261-8225 |
George Andrew Boush, M.D. Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 123 Hospital Dr, Suite 1002, Watertown, WI 53098 Phone: 920-261-8225 Fax: 920-261-5343 | |
Edward J Hoy, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 123 Hospital Dr, Ste 1002, Watertown, WI 53098 Phone: 920-261-8225 Fax: 920-261-5343 | |
Holly C Van Hecke, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 123 Hospital Drive, Suite 1002, Watertown, WI 53098 Phone: 920-261-8225 Fax: 920-261-5343 |