| NPI | 1003883570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK LAREY Executive Director 501-622-1085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2008-09-18 |