| NPI | 1043444714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRANCE E WILSON CEO 765-423-6161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 207X00000X Orthopaedic Surgery | |
| 207Y00000X Otolaryngology | |
| 208600000X Surgery | |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2009-05-11 |