Mitchell William Sullivan, OD
Optometrist in Natchitoches, LA. Individual provider (NPI-1).
NPI number1619705951
StatusActive
Last updated in NPPESMay 1, 2025
Details
- NPI
- 1619705951
- Entity type
- Individual (NPI-1)
- Name
- Mitchell William Sullivan
- Credential
- OD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 25, 2024
- Certification date
- May 1, 2025
- Last updated
- May 1, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 2035-981AT | LA | Yes |
Practice location
118 South DrNatchitoches, LA 71457-5037
Phone 318-352-0444
Mailing address
231 Windermere BlvdAlexandria, LA 71303-3538
Phone 318-487-2020
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All 11 Optometrist providers in Natchitoches · All 836 providers in Natchitoches
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