| NPI | 1083731780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA JACKSON MOORE Medical Doctor 336-389-9898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2010-12-09 |