| NPI | 1053615955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARTLEY TEAGUE Executive Director 731-512-1277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery |
| 208M00000X Hospitalist | |
| 208000000X Pediatrics | |
| 207Q00000X Family Medicine | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 207V00000X Obstetrics & Gynecology | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) | |
| 207T00000X Neurological Surgery | |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2025-10-30 |