| NPI | 1215292941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN MILTON MAGEE Office Manager 601-441-0874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MS 04015) |
| Additional Taxonomies | 2084P0805X (Licence: MS 04015) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2014-07-14 |