Michael W Sullivan, MD - Medicare General Practice in Fort Knox, KY

Michael W Sullivan, MD is a medicare enrolled "General Practice" physician in Fort Knox, Kentucky. His current practice location is 1600 Spearhead Division Ave Dept 140, Fort Knox, Kentucky. You can reach out to his office (for appointments etc.) via phone at (502) 613-4605.

Michael W Sullivan is licensed to practice in Kentucky (license number 30828) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1275576944.

Contact Information

Michael W Sullivan, MD
1600 Spearhead Division Ave Dept 140,
Fort Knox, KY 40122-5104
(502) 613-4605
(502) 613-4549



Physician's Profile

Full NameMichael W Sullivan
GenderMale
SpecialityGeneral Practice
Location1600 Spearhead Division Ave Dept 140, Fort Knox, Kentucky
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1275576944
  • Provider Enumeration Date: 06/13/2006
  • Last Update Date: 06/24/2014
  Medicare PECOS Information:
  • PECOS PAC ID: 1759305741
  • Enrollment ID: I20210616000767

Medical Identifiers

Medical identifiers for Michael W Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1275576944NPI-NPPES
47600743623MedicaidNE
47600743612MedicaidNE
47600743621MedicaidNE
47600743622MedicaidNE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 20770 (Nebraska)Secondary
207V00000XObstetrics & Gynecology 37645020 (Wisconsin)Secondary
208D00000XGeneral Practice 30828 (Kentucky)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Michael W Sullivan is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Michael W Sullivan, MD
1600 Spearhead Division Ave Dept 140,
Fort Knox, KY 40122-5104

Ph: (502) 613-4605
Michael W Sullivan, MD
1600 Spearhead Division Ave Dept 140,
Fort Knox, KY 40122-5104

Ph: (502) 613-4605

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General Practice Doctors in Fort Knox, KY

Dr. Vanessa Jane Shank, M.D.
General Practice
Medicare: Medicare Enrolled
Practice Location: 289 Ireland Ave, Ireland Army Community Hospital, Fort Knox, KY 40121
Phone: 502-624-9864    

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