| NPI | 1174529036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ELMO WILSON President 256-718-2188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: AL 6987) |
| Additional Taxonomies | 208800000X Urology (Licence: MS 15126) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2011-03-16 |