Individual
DR. MANLY JACKSON SULLIVAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MEDICAL DOCTOR
Contact information
Practice address
241 ROBERT K WILSON DR, CARROLLTON, AL 35447-8010
(205) 367-2408
(205) 367-9123
Mailing address
241 ROBERT K WILSON DR, CARROLLTON, AL 35447-8010
(205) 367-2408
(205) 367-9123
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20081
AL
Other
Enumeration date
10/11/2005
Last updated
07/09/2007
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