| NPI | 1205231636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALLIE DALE COGBURN Office Manager 478-254-2644 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: GA 66515) |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2014-10-28 |