| NPI | 1083935910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNESE LEONARD Office Manager 229-446-3773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 043443) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2010-06-15 |