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General NPI Number Information
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NPI Number | 1275744450
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Entity Type | Individual
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Provider Name | FREDERICK CORTNEY SAILES M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/27/2007
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Last Update Date | 06/12/2020
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Provider Practice Location Address
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Address Line | 160 FOUNTAINS BLVD STE B
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City | MADISON
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State | MS
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Zip | 39110-6380
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Country | US
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Telephone | 601-981-2525
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Fax |
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Provider Business Mailing Address
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Address Line | 160 FOUNTAINS BLVD STE B
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City | MADISON
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State | MS
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Zip | 39110-6380
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Country | US
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Telephone | 601-981-2525
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Fax | 601-981-3152
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD427106
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 25MA10417400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | MD427106
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 59513
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License Number State | AZ
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Taxonomy #5
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 302577
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 072112
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License Number State | GA
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Taxonomy #7
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 20642
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License Number State | MS
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Taxonomy #8
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 20642
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License Number State | MS
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