| NPI | 1093259764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE TOPPIN Secretary 662-377-4228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208000000X Pediatrics | |
| 208D00000X General Practice | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2016-12-14 |
| Last Update Date | 2016-12-14 |