Manchester Surgical Assoc

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

DO0000000201 Issued in TN

Legal business name

MANCHESTER SURGICAL ASSOC

Practice address

1239 McArthur Drive
Manchester, TN 37355-2423

Phone

(931) 728-5879

Fax

(931) 728-5881

NPI assigned

Oct 31, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. J David Sullivan, DO

Title

General Surgeon

Phone

(931) 728-5879

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219795200000",
    "number": "1205912102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1228",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373491228",
            "telephone_number": "931-728-5879",
            "fax_number": "931-728-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 MCARTHUR DRIVE",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373552423",
            "telephone_number": "931-728-5879",
            "fax_number": "931-728-5881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANCHESTER SURGICAL ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2008-08-27",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "GENERAL SURGEON",
        "authorized_official_telephone_number": "931-728-5879",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "TN",
            "license": "DO0000000201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3301339",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Manchester Center for Rehabilitation and Healing LLC
• Manchester Eyecare LLC
• Manchester Family Healthcare
• Manchester Family Practice
• Manchester Residential, LLC
• Manning Family Dentistry
• Charlie Dallas Manning IV, D.D.S.
• Lindsay Head Manning, DDS
• Edgar Marceleno
• Thomas H. Marcrom, PHARM. D.

• Surgery Physician in Manchester, TN
• Providers in Manchester, TN by specialty
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.