| NPI | 1194132456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY JORDAN VP Of Payor Relations 844-633-4663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX TX F9123) |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2016-10-26 |