| NPI | 1205208790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE HUBER Medical Director 601-947-1330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2015-12-28 |