NPI | 1215933346 |
---|---|
Doing Business As | SULLIVAN FAMILY MEDICINE CLINIC |
Entity Type | Organization |
Authorized Contact | HURSIE J DAVIS-SULLIVAN Owner And President 601-373-2940 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MS 13888) |
Enumeration Date | 2005-06-23 |
Last Update Date | 2010-11-09 |