| NPI | 1013444058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY WILLIAMS Owner/Provider 662-351-1970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2018-04-23 |