Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 072112 | GA |
N | 208600000X | Surgeon | 072112 | GA |
N | 208200000X | Surgeon | 20642 | MS |
N | 208600000X | Surgeon | 20642 | MS |
N | 208200000X | Surgeon | 25MA10417400 | NJ |
N | 208600000X | Surgeon | 25MA10417400 | NJ |
N | 208200000X | Surgeon | MD427106 | PA |
N | 208600000X | Surgeon | MD427106 | PA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 20642 | MS |
N | 2086S0122X | Plastic and Reconstructive Surgery | 302577 | NY |
N | 2086S0122X | Plastic and Reconstructive Surgery | 59513 | AZ |
N | 2086S0122X | Plastic and Reconstructive Surgery | MD427106 | PA |
NPI | 1275744450 |
---|---|
Provider Name | Frederick Cortney Sailes |
First Address | Madison, MS 39110-6380 |
Second Address | Madison, MS 39110-6380 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2007 |
Last Update Date | 12/06/2020 |