| NPI | 1013207091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI E PARKER Medical Clinic Office Coordinator 601-292-4261 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2011-04-12 |