Organization
MISSISSIPPI CENTER FOR ADVANCED MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SPENCER K SULLIVAN MD (CEO)
(601) 499-0935
Entity
Organization
Contact information
Practice address
7730 OLD CANTON RD BLDG B, MADISON, MS 39110-9299
(601) 499-0935
(601) 499-0936
Mailing address
7731 OLD CANTON RD STE B, MADISON, MS 39110-6115
(601) 499-0935
(601) 499-0936
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/09/2022
Last updated
06/09/2022
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