| NPI | 1003182767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN R STALEY President 888-203-1274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-03-28 |