| NPI | 1013930320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEMMERLY DRAKE THOMAS Billing Manager 501-515-8136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Additional Taxonomies | 207N00000X Dermatology |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2023-04-10 |