| NPI | 1114300753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD CRAIG MCLEAN Medical Director 229-228-6577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 030163) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2015-07-01 |