Bryan Tipton Sullivan, DPM
Podiatrist in Jackson, MS. Individual provider (NPI-1).
NPI number1164592044
StatusActive
Last updated in NPPESJun 5, 2008
Details
- NPI
- 1164592044
- Entity type
- Individual (NPI-1)
- Name
- Bryan Tipton Sullivan
- Credential
- DPM
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 8, 2006
- Last updated
- Jun 5, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 213E00000X | Podiatrist | 80089 | MS | Yes |
Practice location
1915 Dunbarton DriveJackson, MS 39216
Phone 601-982-3338 · Fax 601-982-2253
Mailing address
1915 Dunbarton DriveJackson, MS 39216
Phone 601-982-3338 · Fax 601-982-2253
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- Mississippi Foot And Surgical Center, LLCNPI 1235209115
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All 11 Podiatrist providers in Jackson · All 8,702 providers in Jackson
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