Sullivan, Sabra

Sullivan, Sabra is an sole proprietor health care provider with primary practice located at 501 Marshall St Suite 606, Jackson MS 39202-1651. She recently has only one registered license in Allopathic & Osteopathic Physicians / Procedural Dermatology, which is considered as her primary health care specialty. Sullivan, Sabra can be contacted via phone (601) 355-8555.

Contact Information

Primary practice address
501 Marshall St Suite 606 Jackson MS 39202-1651
Phone: (601) 355-8555
Fax: (601) 355-2244
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X 14238 Mississippi

Profile Details

NPI number 1932176641
LBN Legal business name Sullivan, Sabra
Credentials M.D., PHD.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 1st, 2006
Last updated Jun 14th, 2010 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932176641 NPPES
Mississippi MEDICAID 0114928

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