Bryan T Sullivan
LBN: Mississippi Foot And Surgical Center, Llc
Bryan T Sullivan is an health care organization with primary practice located at 1915 Dunbarton Drive , Jackson MS 39216. The organization recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as the primary health care specialty.
Mississippi Foot And Surgical Center, Llc can be contacted via phone (601) 982-3338, or through Sullivan, Bryan Tipton via phone (601) 982-3338.
Contact Information
Primary practice address
1915 Dunbarton Drive
Jackson MS 39216
Phone: (601) 982-3338
Fax: (601) 982-2253
Website:
Authorized official contact:
Name: Sullivan, Bryan Tipton Doctor of Podiatric Medicine (DPM)
Phone: (601) 982-3338
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 80089 | Mississippi |
Profile Details
| NPI number | 1235209115 |
|---|---|
| LBN Legal business name | Mississippi Foot And Surgical Center, Llc |
| DBA Doing business as | Bryan T Sullivan |
| Authorized official | Sullivan, Bryan Tipton Doctor of Podiatric Medicine (DPM) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 8th, 2006 |
| Last updated | Jun 19th, 2008 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235209115 | NPPES |
| Mississippi | MEDICAID | 00012910 | |
| Mississippi | Other | 480007636 |
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