| NPI | 1093914392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMBERLY L MCCOY Dr 270-926-1150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2023-06-14 |