| NPI | 1144390121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK R FORTSON President 706-653-1072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 024937) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |