| NPI | 1194736009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARICE D KENNEDY Provider Enrollment Specialist 205-995-7980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 152834) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2008-04-20 |