| NPI | 1164740700 |
|---|---|
| Doing Business As | MEMORIAL PHYSICIAN NETWORK - PEDIATRIC SUBSPECIALTY |
| Entity Type | Organization |
| Authorized Contact | MARY JO YANTIS Vice President 719-365-9951 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 174400000X Specialist |
| Enumeration Date | 2010-05-06 |
| Last Update Date | 2010-06-16 |