| NPI | 1194785170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAM KLEBOSITS Practice Administrator 229-259-4660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 261QE0002X Clinic/Center, Emergency Care |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2008-12-12 |