| NPI | 1124299599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRAN L STUCKS Administrator 870-534-5533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AR R4495) |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2024-01-11 |