Organization
MISSISSIPPI CENTER FOR ADVANCED MEDICINE, PC
Active
Parent organization
MISSISSIPPI CENTER FOR ADVANCED MEDICINE, PC
Other names
Louisiana Center for Advanced Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
MISSISSIPPI CENTER FOR ADVANCED MEDICINE, PC
Authorized official
SPENCER K SULLIVAN (CEO/OWNER)
(601) 499-0935
Entity
Organization
Contact information
Practice address
2053 GAUSE BLVD E STE 200, SLIDELL, LA 70461-5451
(985) 259-8045
(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
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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