| NPI | 1144822628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALLAS EVANS Chief Practitioner 904-438-5211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RT0003X Internal Medicine Transplant Hepatology |
| Additional Taxonomies | 282NC0060X General Acute Care Hospital Critical Access |
| 363LA2200X Nurse Practitioner Adult Health | |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2020-11-10 |