Mississippi Center for Advanced Medicine, PC

NPI #1508426917 in Slidell, Louisiana

Provider Information

NPI Number: 1508426917
Entity Type: Organization
Organization Name: Mississippi Center for Advanced Medicine, PC
Subpart: Yes (part of a larger organization)
Parent Organization: MISSISSIPPI CENTER FOR ADVANCED MEDICINE, PC
Primary Specialty: Specialist
Enumeration Date: Jun 18, 2019
Last Updated: Jun 18, 2019

Practice Location

Address: 2053 GAUSE BLVD E STE 200
City: Slidell
State: Louisiana
ZIP Code: 70461-5451
Phone: (985) 259-8045

Authorized Official

Name: SPENCER K SULLIVAN
Title: CEO/OWNER
Phone: (601) 499-0935

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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