| NPI | 1225080062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD HOLD Secretary 706-629-2895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2015-09-14 |