Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Timothy John Sullivan III, MD

Individual provider Allergy Physician · NPI 1023012911

Dr. Timothy John Sullivan III, MD is an Allergy/Immunology in Ogden, Utah. Graduated from University of Miami, Lm Miller School of Medicine in 1966, 60 years ago. Practices with Vicki J Lyons MD PC, a 4-clinician group and accepts Medicare assignment. Licensed in Georgia and Utah.

Years since qualifying
60
Trained at
University of Miami, Lm Miller School of Medicine
Licensed in
GA, UT
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4403 Harrison Blvd Ste 4640
Ogden, UT 84403-3304
Phone: (801) 387-4850
Fax: (801) 387-4855
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Allergy Physician (primary) Taxonomy 207KA0200X · Licence 8263858-1205 (UT)
Allergy Physician Taxonomy 207KA0200X · Licence 037913 (GA)

Record details

NPI number1023012911
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 8, 2005
Last updated in NPPESJune 3, 2015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyALLERGY/IMMUNOLOGY
Medical schoolUNIVERSITY OF MIAMI, LM MILLER SCHOOL OF MEDICINE
Graduated 1966 (60 years in practice)
Group practice Vicki J Lyons Md Pc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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