| NPI | 1093730533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN R PHILLIPS Medical Services Manager 501-624-6217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: AR 107) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2012-08-21 |