NPI | 1144494022 |
---|---|
Entity Type | Organization |
Authorized Contact | TERESA B BASKIN Registered Nurse 601-743-5121 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MS 376J00000X) |
Enumeration Date | 2008-04-22 |
Last Update Date | 2009-03-29 |