| NPI | 1033377882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY MICHELE JACKSON Medical Assistant/ Office Manager 706-733-9447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 017877) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2008-05-29 |