| NPI | 1164606596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEIGH ANN CRAVEN Office Manager 904-732-5084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0053198) |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2007-12-20 |