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Contact Information

LACEY SULLIVAN, MD
2809 DENNY AVE
PASCAGOULA, MS39581
 Phone: 228-818-6063
 Fax: 228-809-2254
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for LACEY SULLIVAN · (Female)

NPI Number 1962707745
Status Active
Credentials MD
Entity Individual
Enumeration date 01/25/2011
Last updated 06/03/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • AL License # MD.35922
Hospital affiliation(s)
  • MEMORIAL HOSPITAL AT GULFPORT - (Acute Care)
    4500 13TH ST-P O BOX 1810
    GULFPORT, MS 39502
  • SINGING RIVER HOSPITAL - (Acute Care)
    2809 DENNY AV
    PASCAGOULA, MS 39581
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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