| Dr Manly Jackson Sullivan, MEDICAL DOCTOR | |
|
241 Robert K Wilson Dr, Carrollton, AL 35447-8010 | |
| (205) 367-2408 | |
| (205) 367-9123 |
| Full Name | Dr Manly Jackson Sullivan |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 30 Years |
| Location | 241 Robert K Wilson Dr, Carrollton, Alabama |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003804352 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 20081 (Alabama) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Fayette Medical Center | Fayette, AL | Hospital |
| Northwest Medical Center | Winfield, AL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Nwmc Emergency Physicians Llc | 0941604169 | 11 |
| Relias Emergency Medicine Specialists Of Fayette Llc | 6800147604 | 9 |
| Entity Name | Lakeland Physicians, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851780951 PECOS PAC ID: 0446578298 Enrollment ID: O20150408000559 |
| Entity Name | Relias Emergency Medicine Specialists Of Fayette Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093201543 PECOS PAC ID: 6800147604 Enrollment ID: O20180918001531 |
| Entity Name | Nwmc Emergency Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134708506 PECOS PAC ID: 0941604169 Enrollment ID: O20210811000258 |
| Entity Name | Sycamore Lakeland Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184472789 PECOS PAC ID: 2668915471 Enrollment ID: O20240621001173 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Manly Jackson Sullivan, MEDICAL DOCTOR 241 Robert K Wilson Dr, Carrollton, AL 35447-8010 Ph: (205) 367-2408 | Dr Manly Jackson Sullivan, MEDICAL DOCTOR 241 Robert K Wilson Dr, Carrollton, AL 35447-8010 Ph: (205) 367-2408 |
Dr. William R Brooke, MEDICAL DOCTOR Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 241 Robert K Wilson Dr, Carrollton, AL 35447 Phone: 205-367-2408 Fax: 205-367-9123 | |
Dr. Nikki Lee Christensen, MEDICAL DOCTORS Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 241 Robert K Wilson Dr, Carrollton, AL 35447 Phone: 205-367-2408 Fax: 205-367-9123 |