| NPI | 1033589163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE TOPPIN Corporate Secretary 662-377-4229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2025-01-20 |