| NPI | 1184688244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN JACKSON Credentialing Manager 205-715-5943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2018-01-08 |