| NPI | 1184590739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELDA JOHNSON CEO 256-836-0853 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2025-10-13 |
| Last Update Date | 2025-10-13 |