NPI 1164592044

Bryan Tipton Sullivan, DPM

Practitioner Podiatrist Jackson, MS

Practice location

Address: 1915 Dunbarton Drive, Jackson, MS 39216
Phone: (601) 982-3338
Fax: (601) 982-2253

Registered specialties

Podiatrist Primary

Podiatric Medicine & Surgery Service Providers Taxonomy 213E00000X Licence 80089 (MS)

Other Podiatrist providers in Mississippi →

Registry record

NPI: 1164592044
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Nov 2006
Record last updated: 5 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.