| NPI | 1023432192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON PACE Office Manager 334-291-8360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2023-07-18 |