| NPI | 1063927465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MCMAHON CEO 769-243-6141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 2086S0129X Surgery, Vascular Surgery | |
| 208D00000X General Practice | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2023-02-10 |