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1235284928
GRENADA LAKE INPATIENT MEDICINE ASSOCIATES
GRENADA, MS
NPI
1235284928
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Entity Type
Organization
Authorized Contact
KEITH HEARTSILL
CFO
662-227-7172
Organization Subpart ?
No
Primary Taxonomy
207R00000X Internal Medicine
Enumeration Date
2007-01-24
Last Update Date
2008-04-20
Business Address
GRENADA LAKE INPATIENT MEDICINE ASSOCIATES
960 J K AVENT DR
GRENADA, MS 38901-5230
Phone number: 662-227-7492
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Mailing Address
GRENADA LAKE INPATIENT MEDICINE ASSOCIATES
PO BOX 52007
ATLANTA, GA 30355-0007
Phone number: 678-397-0060
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