| NPI | 1164562468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK PHILLIPS Third Party Billing 601-576-7566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MS R511587) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |