| NPI | 1033412846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONICA WOODS ELLIS Practice Administrator 901-755-7069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN MD016474) |
| Enumeration Date | 2010-12-16 |
| Last Update Date | 2013-01-16 |