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

Individual provider Athletic Trainer · NPI 1942817895

Thaxton Sullivan is an Athletic Trainer in Hinesville, Georgia. Practices as a sole proprietor and works from 2 locations. Licensed in Texas.

Licensed in
TX
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

572 Essayons Dr 92nd Engineer Bn
Hinesville, GA 31313-3131
Phone: (601) 422-7472
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3 Courtland Dr Apt 50, Hattiesburg, MS 39402-8186 — (601) 422-7472

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence AT9120 (TX)
Athletic Trainer Taxonomy 2255A2300X

Record details

NPI number1942817895
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 24, 2020
Last updated in NPPESMarch 22, 2023
Certification dateMarch 20, 2023
Mailing address3 Courtland Dr Apt 50, Hattiesburg, MS 39402-8186

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