Individual
DR. WILLIAM BRUNS SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
109 MILLSAPS DR, SUITE C, HATTIESBURG, MS 39402-1348
(601) 268-5051
(601) 268-5054
Mailing address
109 MILLSAPS DR, SUITE C, HATTIESBURG, MS 39402-1587
(601) 268-5051
(601) 268-5054
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12999
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00118398
—
MS
Enumeration date
05/02/2006
Last updated
05/08/2013
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