| NPI | 1013142017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE BUTLER Cbo Manager 601-663-1423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MS 80193) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2009-05-19 |