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 |