| NPI | 1154867562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEONNE HENRY Director Of Operations 662-432-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 208800000X Urology |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2023-10-24 |