Healthcare Provider Details

I. General information

NPI: 1083349344
Provider Name (Legal Business Name): SLS CONSULTATION FIRM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2022
Last Update Date: 07/21/2022
Certification Date: 07/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

971 LAKELAND DR STE 661
JACKSON MS
39216-4608
US

IV. Provider business mailing address

971 LAKELAND DR STE 661
JACKSON MS
39216-4608
US

V. Phone/Fax

Practice location:
  • Phone: 601-899-3990
  • Fax:
Mailing address:
  • Phone: 601-899-3990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FREDERICK CORTNEY SAILES
Title or Position: CEO
Credential: M.D.
Phone: 601-899-3990