Sullivan, William David
Sullivan, William David is an individual health care provider with primary practice located at 1203 Jefferson St , Laurel MS 39440-4354. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Sullivan, William David can be contacted via phone (601) 649-2863.Contact Information
Primary practice address
1203 Jefferson St
Laurel MS 39440-4354
Phone: (601) 649-2863
Fax: (601) 649-9479
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 15587 | Mississippi |
Profile Details
| NPI number | 1659385276 |
|---|---|
| LBN Legal business name | Sullivan, William David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 28th, 2006 |
| Last updated | Jul 11th, 2013 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659385276 | NPPES |
| Mississippi | MEDICAID | 00119394 |
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