| NPI | 1073544508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN MORRIS Billing 870-234-5995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2012-06-19 |