NPI | 1104138643 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN D MORRIS Owner 256-255-0228 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 17629) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-054737) |
363LA2100X Nurse Practitioner, Acute Care (Licence: AL 1-060971) | |
Enumeration Date | 2010-07-13 |
Last Update Date | 2010-07-13 |