Individual
DR. SUZANNE R SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1026 N FLOWOOD DR, FLOWOOD, MS 39232-9532
(601) 932-1000
Mailing address
PO BOX 321360, FLOWOOD, MS 39232-1360
(601) 936-0681
(601) 936-0686
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
09191
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115788
—
MS
Enumeration date
08/22/2006
Last updated
07/08/2007
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