IndividualActive
John Sullivan, MD
NPI 1043872948 · Plastic and Reconstructive Surgery Physician · Jackson, MS
Provider details
- NPI number
- 1043872948
- Entity type
- Individual
- Primary specialty
- Plastic and Reconstructive Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- T-3879 (MS)
Mailing address
37 Enclave Cir
Ridgeland, MS 39157-4522
Registry dates
- Enumerated
- 2019-07-01
- Last updated
- 2019-07-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.