| NPI | 1093142598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY LORRAINE NOONAN Director, Physician Business Servic 228-575-1740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 207RH0003X Internal Medicine, Hematology & Oncology | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 207RN0300X Internal Medicine, Nephrology | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 207RR0500X Internal Medicine, Rheumatology | |
| 207RX0202X Internal Medicine, Medical Oncology | |
| 207T00000X Neurological Surgery | |
| 207X00000X Orthopaedic Surgery | |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2024-01-09 |