| NPI | 1063812683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNYCE RAMONA CAMPBELL Physician 769-257-5713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 08563) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2014-09-02 |