| NPI | 1033212634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA REYNOLDS Practice Administrator 229-243-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-08-22 |