Sullivan Family Medicine Clinic

LBN: Heeers, Pa
Sullivan Family Medicine Clinic is an health care organization with primary practice located at 1814 Hospital Dr , Jackson MS 39204-3410. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Heeers, Pa can be contacted via phone (601) 373-2940, or through Davis-Sullivan, Hursie J via phone (601) 373-2940.

Contact Information

Primary practice address
1814 Hospital Dr Jackson MS 39204-3410
Phone: (601) 373-2940
Fax: (601) 373-2720
Website:
Map and Directions
Authorized official contact:
Name: Davis-Sullivan, Hursie J Doctor of Medicine (MD)
Phone: (601) 373-2940

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X 13888 Mississippi

Profile Details

NPI number 1215933346
LBN Legal business name Heeers, Pa
DBA Doing business as Sullivan Family Medicine Clinic
Authorized official Davis-Sullivan, Hursie J Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 23rd, 2005
Last updated Nov 9th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215933346 NPPES
Mississippi MEDICAID 08236531
Mississippi MEDICAID 00112110

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