| NPI | 1083925960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ODETTE LOUISE CAMPBELL Owner 469-671-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX H9609) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX H9609) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2024-01-22 |