Manly Jackson Sullivan MEDICAL DOCTOR

NPI 1003804352 - Emergency Medicine - 207P00000X

NPI Details
NPI 1003804352
Gender Male
Enumeration Date 10/11/2005
Last Updated 07/09/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
241 ROBERT K WILSON DR
CARROLLTON AL, 35447-8010, US
Phone (205) 367-2408
Fax (205) 367-9123
Business Location
241 ROBERT K WILSON DR
CARROLLTON AL, 35447-8010, US
Phone (205) 367-2408
Fax (205) 367-9123
Toxanomy
Taxonomy Code 207P00000X
License State Alabama
License Number 20081
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According to our database, Dr. Manly Jackson Sullivan MEDICAL DOCTOR NPI is 1003804352, taxonomy code is 207P00000X and license number is 20081, license state is located at Alabama. Manly Jackson Sullivan MEDICAL DOCTOR physically located at 241 Robert K Wilson Dr, Carrollton AL, 35447-8010. NPI Number Manly Jackson Sullivan MEDICAL DOCTOR has the Individual type.

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1003804352 NPI number is provided on an as is basis without warranty of any kind. 1003804352 is maintained by the National Plan & Provider Enumeration System. The contents of Manly Jackson Sullivan MEDICAL DOCTOR are for informational purposes only.