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Thaxton Sullivan
NPI 1942817895 · on the registry since 2020 · sole proprietor
Practice
- Address
- 572 Essayons Dr.
92nd Engineer Bn
Hinesville, GA 31313 - Phone
- (601) 422-7472
Additional practice sites
- 3 Courtland Dr Apt 50, Hattiesburg, MS
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Also registered as
- 2255A2300X
- Licence states on file
- TX
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-03-22
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia