| NPI | 1205022647 |
|---|---|
| Doing Business As | JCT MEDICAL/RUSSELL W. TYNES MD |
| Entity Type | Organization |
| Authorized Contact | RUSSELL W. TYNES Medical Director 318-212-1610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: LA 016884) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2009-04-29 |