| NPI | 1053646190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LYNN HILLIARD Family Nurse Practitioner 601-209-8432 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: MS R656046) |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2011-11-18 |