Spencer K Sullivan
Pediatric Hematology-Oncologist
7730 Old Canton Rd Bldg B
Madison
, Mississippi 39110
Spencer K Sullivan
Pediatric Hematology-Oncologist
7730 Old Canton Rd Bldg B
Madison
, Mississippi 39110
(601) 499-0936
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About
Features
Specialties
- Pediatric Hematology-Oncologist
Languages spoken
- English
Location
First Address
- Spencer K Sullivan
- 7731 Old Canton Rd Ste B
- Madison, MS
- Zip : 39110-6115
- Fax : (601) 499-0936
- Phone : (601) 499-0935
Second Address
- Spencer K Sullivan
- 7730 Old Canton Rd Bldg B
- Madison, MS
- Zip : 39110
- Fax : (601) 499-0936
- Phone : (601) 499-0935
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0207X | Pediatric Hematology-Oncologist | 23304 | MS |
National Provider Identifier
| NPI | 1073735114 |
|---|---|
| Provider Name | Spencer K Sullivan |
| First Address | Madison, MS 39110-6115 |
| Second Address | Madison, MS 39110 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/05/2007 |
| Last Update Date | 18/06/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 01212067 | (05) | MS |
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.