Mississippi Center for Advanced Medicine, PC

NPI #1790227627 in Madison, Mississippi

Provider Information

NPI Number: 1790227627
Entity Type: Organization
Organization Name: Mississippi Center for Advanced Medicine, PC
Primary Specialty: Specialist
Enumeration Date: Nov 9, 2016
Last Updated: Dec 21, 2016

Practice Location

Address: 7731 OLD CANTON RD
Address 2: SUITE B
City: Madison
State: Mississippi
ZIP Code: 39110-6114
Phone: (601) 499-0935

Authorized Official

Name: DR. SPENCER K SULLIVAN, M.D.
Title: PRESIDENT/CEO
Phone: (601) 499-0935

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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