| NPI | 1184165102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER R DAVIS Office Manager 662-769-5006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: MS 18626) |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2017-03-09 |