Organization
THE CUTANEOUS LASER CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SABRA SULLIVAN M.D.PHD (MANAGER)
(601) 355-8555
Entity
Organization
Contact information
Practice address
501 MARSHALL ST STE 606, JACKSON, MS 39202-1650
(601) 355-8555
(601) 355-2244
Mailing address
501 MARSHALL ST STE 606, JACKSON, MS 39202-1650
(601) 355-8555
(601) 355-2244
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
14238
MT
Other
Enumeration date
10/18/2007
Last updated
10/18/2007
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