| NPI | 1053475541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BECKETT HENGHOLD Physician 850-474-4775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME 92467) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2008-02-13 |