Dr. Manly Jackson Sullivan
Emergency Physician
241 Robert K Wilson Dr
Carrollton
, Alabama 35447-8010
Dr. Manly Jackson Sullivan
Emergency Physician
241 Robert K Wilson Dr
Carrollton
, Alabama 35447-8010
(205) 367-9123
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About
Features
Specialties
- Emergency Physician
Languages spoken
- English
Location
First Address
- Dr. Manly Jackson Sullivan
- 241 Robert K Wilson Dr
- Carrollton, AL
- Zip : 35447-8010
- Fax : (205) 367-9123
- Phone : (205) 367-2408
Second Address
- Dr. Manly Jackson Sullivan
- 241 Robert K Wilson Dr
- Carrollton, AL
- Zip : 35447-8010
- Fax : (205) 367-9123
- Phone : (205) 367-2408
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207P00000X | Emergency Physician | 20081 | AL |
National Provider Identifier
| NPI | 1003804352 |
|---|---|
| Provider Name | Dr. Manly Jackson Sullivan |
| First Address | Carrollton, AL 35447-8010 |
| Second Address | Carrollton, AL 35447-8010 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/10/2005 |
| Last Update Date | 09/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| G42261 | (02) | AL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.