| NPI | 1164830576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY KAYE REYNOLDS Credentialing, Audit & Complaince 501-801-8436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2014-07-29 |