LACEY SULLIVAN


Address: 2809 Denny Ave, Pascagoula, MS 39581
Phone: 2288186063

LACEY SULLIVAN (NPI# 1962707745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1962707745
Entity Type Individual
Full Name LACEY SULLIVAN
Credential M.D.
Practice Address 2809 Denny Ave
Pascagoula
MS 39581
Mailing Address 5052 W 4th St Ste 7
Hattiesburg
MS 39402-1069
Practice Telephone 2288186063
Practice Fax Number 2288092254
Mailing Telephone 6012612587
Mailing Fax Number 6012647426
Enumeration Date 2011-01-25
Last Update Date 2019-06-03
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207ZP0102X Pathology
Specialization: Anatomic Pathology & Clinical Pathology
MD.35922 AL Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
3109 Bienville Blvd, Ocean Springs, MS 395644361 2288184056

Other Providers LACEY SULLIVAN

NPI Name Taxonomy Address Enumeration
1194070235 Lacey Jay Sullivan Pharmacist 21132 N 36th Pl, Phoenix, AZ 85050-8386 2012-07-15
1114412103 Lacey Sullivan Dentist 1141 Jasper Dennis Rd, Clanton, AL 35045 2018-06-22
1174951503 Lacey Sullivan Nurse Practitioner 618 Maple Valley Dr, Farmington, MO 63640 2013-10-22

Office Location

Street Address 2809 DENNY AVE
City PASCAGOULA
State MS
Zip Code 39581

Providers in the same location

NPI Name Taxonomy Address Enumeration
1154316032 Debby Ann Koffskey-beech Social Worker 2809 Denny Ave, Pascagoula, MS 39581-5301 2005-09-15
1356941397 Lindsey Nicole Mcfaul Registered Nurse 2809 Denny Ave, Pascagoula, MS 39581-5301 2020-10-28
1457958910 Courtney Tucker Nurse Practitioner 2809 Denny Ave, Pascagoula, MS 39581-5301 2020-10-07
1811502628 Hillary Paige Weaver Nurse Practitioner 2809 Denny Ave, Pascagoula, MS 39581-5301 2020-09-09
1316559891 Ashley Ann Gaffney Registered Nurse 2809 Denny Ave, Pascagoula, MS 39581-5301 2020-08-17
1851938898 Singing River Health System Pharmacy 2809 Denny Ave, Pascagoula, MS 39581-5301 2019-12-10
1295379741 Shelby Alexis Parker Speech-Language Pathologist 2809 Denny Ave, Pascagoula, MS 39581-5301 2019-10-28
1366083040 Kyla Austin Richburg Nurse Practitioner 2809 Denny Ave, Pascagoula, MS 39581-5300 2019-10-03
1124586086 Anganatte Nicole Williams Nurse Practitioner 2809 Denny Ave, Pascagoula, MS 39581-5301 2019-03-08
1205394442 Kyrissa Malley Dietitian, Registered 2809 Denny Ave, Pascagoula, MS 39581-5301 2019-03-06
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1760945448 Jacquelyn B Ellison Nurse Practitioner 4105 Hospital Road, Ste 103, Pascagoula, MS 39581 2019-04-10
1104346816 Jennifer Ngoc Bui Dentist 4001 Denny Ave Suite 1, Pascagoula, MS 39581 2017-06-23
1528486289 Thomas Stallworth Nurse Practitioner 4105 Hospital St Ste 104, Pascagoula, MS 39581 2014-03-31
1487919957 Candace Noel Pendowski Nurse Practitioner 4211 Hospital St Suite 208, Pascagoula, MS 39581 2012-07-10
1649548892 Kim M. Tumminello Nurse Practitioner 4253 Denny Avenue, Pascagoula, MS 39581 2011-12-02
1649547860 Abrian Norell Flowers Physical Therapist 3537 Denny Avenue, Suite 115, Pascagoula, MS 39581 2011-11-17
1164724118 Coast To Coast Rehab LLC Rehabilitation Practitioner 3537 Denny Ave, Suite 115, Pascagoula, MS 39581 2010-11-24
1740500958 Joshua Eric Tucker Physical Medicine & Rehabilitation 4105 Hospital St Ste 112b, Pascagoula, MS 39581 2010-06-10
1720164916 Vernon W Doster Family Medicine 3616 Hospital Street, Suite D, Pascagoula, MS 39581 2006-10-31
1841387727 David Bruce Allen Thoracic Surgery (Cardiothoracic Vascular Surgery) 4300 Hospital Rd, Suite 105, Pascagoula, MS 39581 2006-10-10
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Taxonomy Information

Taxonomy Code 207ZP0102X
Grouping Allopathic & Osteopathic Physicians
Classification Pathology
Specialization Anatomic Pathology & Clinical Pathology

Taxonomy Definition

A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1356497416 Jerry Pascall Moore Pathology 146 Road 83, Tupelo, MS 38801-6971 2007-01-25
1477601177 Forrest County General Hospital Pathology 300 S 29th Ave, Hattiesburg, MS 39401-7127 2007-01-08
1417027376 Brad Elliot Wheeler Pathology 300 Fisher Street, Biloxi, MS 39534 2006-11-08
1003904012 Susan Strong Cannon Pathology 15 Summer Trace Blvd, Laurel, MS 39440-2510 2006-10-11
1386738920 Celeste Lois Cook-glenn Pathology 413 Audubon Ct, Madison, MS 39110-6910 2006-10-03
1497849533 Midsouth Pathology Associates Pathology 105 Lower Woodville Rd, Natchez, MS 39120 2006-10-03
1780787143 Lisa Chandler Pathology 1207 Office Park Dr., Suite A, Oxford, MS 38655 2006-09-07
1215049929 Clay Broders Calcote Pathology 1500 E Woodrow Wilson Dr, Jackson, MS 39216-5116 2006-08-31
1548206501 James W Lewis Pathology 123 Main St N, Amory, MS 38821-3416 2006-06-20
1174565469 Vettaikorumakankav V Vedanarayanan Pathology 401 Baptist Dr Ste 301, Madison, MS 39110-2012 2006-06-12
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Competitor

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City PASCAGOULA
Zip Code 39581

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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