| NPI | 1194114033 |
|---|---|
| Other Name | NONE |
| Entity Type | Organization |
| Authorized Contact | DONALD LEWIS Md 731-422-4642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: TN md0000005534) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2015-01-15 |