| NPI | 1154625226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLE HOPE HADDOCK Office Manager 912-681-7111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 051598) |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2011-01-05 |