| Dr Jennifer O'sullivan, MD | |
|
297 Highway 51 Ste B, Ridgeland, MS 39157-3423 | |
| (601) 707-5381 | |
| (601) 707-5382 |
| Full Name | Dr Jennifer O'sullivan |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 297 Highway 51 Ste B, Ridgeland, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487731204 | NPI | - | NPPES |
| 03232771 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 19346 (Mississippi) | Primary |
| Entity Name | Childrens Hospital Medical Practice Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821090713 PECOS PAC ID: 5597944579 Enrollment ID: O20110124000073 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jennifer O'sullivan, MD 297 Highway 51 Ste B, Ridgeland, MS 39157-3423 Ph: (601) 707-5381 | Dr Jennifer O'sullivan, MD 297 Highway 51 Ste B, Ridgeland, MS 39157-3423 Ph: (601) 707-5381 |
Dr. Shamika Rochelle Hudson, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 297 Highway 51 Ste B, Ridgeland, MS 39157 Phone: 601-707-5381 Fax: 601-707-5382 | |
Yolanda W Wilson, M. D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 297 Highway 51 Ste B, Ridgeland, MS 39157 Phone: 601-707-5381 Fax: 601-707-5382 | |
Courtney Rey Convertino, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 6919 Old Canton Rd, Ridgeland, MS 39157 Phone: 601-956-0911 | |
Leigh Rhodes Campbell, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 272 S Perkins St Ste 200, Ridgeland, MS 39157 Phone: 601-521-3196 Fax: 601-510-8440 | |
Russell Ray Lyle, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 303 Hunter Crest, Ridgeland, MS 39157 Phone: 601-605-9995 |