| NPI | 1033413018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI LANGSTON Payer Relations Specialist 470-816-9108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 014050) |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2022-06-06 |