| NPI | 1205634037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BYRON SHIPP Authorized Official 662-234-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QS0132X Clinic/Center, Ophthalmologic Surgery |
| Enumeration Date | 2025-03-06 |
| Last Update Date | 2025-09-16 |