| Sullivan Family Medicine Clinic | |
|
1814 Hospital Dr Jackson MS 39204-3410 | |
| (601) 373-2940 | |
| (601) 373-2720 |
| Full Name | Sullivan Family Medicine Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1814 Hospital Dr, Jackson, Mississippi |
| Authorized Official Name and Position | Hursie J Davis-sullivan (OWNER AND PRESIDENT) |
| Authorized Official Contact | 6013732940 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sullivan Family Medicine Clinic 1814 Hospital Dr Jackson MS 39204-3410 Ph: (601) 373-2940 | Sullivan Family Medicine Clinic 1814 Hospital Dr Jackson MS 39204-3410 Ph: (601) 373-2940 |
| NPI Number | 1215933346 |
|---|---|
| Provider Enumeration Date | 06/23/2005 |
| Last Update Date | 11/09/2010 |
| Medicare PECOS PAC ID | 2668472317 |
|---|---|
| Medicare Enrollment ID | O20101103000885 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215933346 | NPI | - | NPPES |
| 08236531 | Medicaid | MS | |
| 00112110 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 13888 (Mississippi) | Primary |
| Provider Name | Hursie Jean Davis-sullivan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912104159 PECOS PAC ID: 0042404006 Enrollment ID: I20101103001037 |
Ben W. Seale, M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 971 Lakeland Dr, Suite 450, Jackson, MS 39216 Phone: 601-948-5158 Fax: 601-949-6058 | |
Central Mississippi Health Services, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3450 Highway 80 W Ste 71, Jackson, MS 39209 Phone: 601-321-2400 | |
Hni Medical Services Of Mississippi, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 969 Lakeland Dr, Jackson, MS 39216 Phone: 601-200-2000 | |
Medical Care Associates Mobile Unit Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3855 Azalea Dr, Jackson, MS 39206 Phone: 601-366-9447 | |
The Wound Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1850 Chadwick Dr, Jackson, MS 39204 Phone: 601-376-2561 Fax: 601-376-2570 | |
Quad Intermed Company Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5005 Old Canton Rd, Jackson, MS 39211 Phone: 601-957-3333 | |
Vanessa L. Sandifer, M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 971 Lakeland Drive, Suite 450, Jackson, MS 39216 Phone: 601-948-5158 Fax: 601-949-6058 |