Sullivan, Lisa Myers

Sullivan, Lisa Myers is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is her primary health care specialty. Sullivan, Lisa Myers can be contacted via phone (601) 984-1530.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-1530
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 23387 Mississippi
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 0116017500 Virginia

Profile Details

NPI number 1497976617
LBN Legal business name Sullivan, Lisa Myers
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2007
Last updated Nov 11th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1497976617 NPPES
Alabama MEDICAID 178238
Alabama MEDICAID 07704363

Popular Providers