| NPI | 1184779381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA L MITCHELL Office Manager 731-587-3454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 0000011832) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2015-03-23 |