| NPI | 1073564217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA SIMONTON LAND Manager 478-475-1299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363L00000X Nurse Practitioner | |
| 363A00000X Physician Assistant | |
| 208M00000X Hospitalist | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2016-12-19 |