| NPI | 1013500552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN C SIMON Md / Owner 985-256-5599 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2021-02-16 |
| Last Update Date | 2021-02-18 |