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DR. MANLY JACKSON SULLIVAN MEDICAL DOCTOR NPI 1003804352


NPI Information

NPI: 1003804352
Provider Name: DR. MANLY JACKSON SULLIVAN, MEDICAL DOCTOR
Classification: Emergency Medicine - 207P00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
241 ROBERT K WILSON DR
CARROLLTON, AL
ZIP 35447
Phone: (205) 367-2408
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DR. Manly Jackson Sullivan, MEDICAL DOCTOR is an emergency medicine in Carrollton, AL with 29 years of experience. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. DR. Manly Jackson Sullivan, MEDICAL DOCTOR NPI is 1003804352. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduation Year:1995

The provider's business location address is:

241 ROBERT K WILSON DR
CARROLLTON, AL
ZIP 35447-010
Phone: (205) 367-2408
Fax: (205) 367-9123

The NPI 1003804352 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/11/2005 and was last updated on 7/9/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207P00000XEmergency Medicine20081ALABAMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
133998MEDICARE ID-TYPE UNSPECIFIEDALABAMAPROVIDER NUMBER
2G42261MEDICARE UPINALABAMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.