Organization
MANCHESTER SURGICAL ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J DAVID SULLIVAN DO (GENERAL SURGEON)
(931) 728-5879
Entity
Organization
Contact information
Practice address
1239 MCARTHUR DRIVE, MANCHESTER, TN 37355-2423
(931) 728-5879
(931) 728-5881
Mailing address
PO BOX 1228, MANCHESTER, TN 37349-1228
(931) 728-5879
(931) 728-5881
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
DO0000000201
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3301339
—
TN
Enumeration date
10/31/2006
Last updated
08/27/2008
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