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 |