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Contact Information

MISSISSIPPI FOOT AND SURGICAL CENTER, LLC
1915 DUNBARTON DRIVE
JACKSON, MS39216
 Phone: 601-982-3338
 Fax: 601-982-2253
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for MISSISSIPPI FOOT AND SURGICAL CENTER, LLC

NPI Number 1235209115
LBN Legal business name MISSISSIPPI FOOT AND SURGICAL CENTER, LLC
Authorized official BRYAN SULLIVAN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/08/2006
Last updated 06/19/2008 - About 18 years ago
Identifiers
MS License # 80089
MS Medicaid 00012910
Other 480007636 RAILROAD MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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