Individual
LACEY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2809 DENNY AVE, PASCAGOULA, MS 39581
(228) 818-6063
(228) 809-2254
Mailing address
5052 W 4TH ST STE 7, HATTIESBURG, MS 39402-1069
(601) 261-2587
(601) 264-7426
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD.35922
AL
Other
Enumeration date
01/25/2011
Last updated
06/03/2019
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