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

Individual provider Physician Assistant · NPI 1700023348

Mark Montogomery Sullivan, PAC, MPAS is a Physician Assistant in Murray, Utah. Qualified in 2008, 18 years ago. Practices with Ihc Health Services Inc, a 3,947-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
18
Licensed in
UT
In the registry since
2009
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

5121 Cottonwood St Ste 320
Murray, UT 84107-5701
Phone: (801) 507-3380
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 7131889-1206 (UT)

Record details

NPI number1700023348
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC , MPAS
Sole proprietorNo
NPI enumeratedJanuary 20, 2009
Last updated in NPPESJanuary 25, 2010

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Ihc Health Services Inc — 3947 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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