NPI | 1245393255 |
---|---|
Doing Business As | ST DOMINIC FAMILY PRACTICE ASSOCIATES MADISON |
Doing Business As | ST DOMINIC FAMILY PRACTICE ASSOCIATES GLUCKSTADT |
Entity Type | Organization |
Authorized Contact | DANIELLE STUART Credentialing Specialist 601-200-4880 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2006-12-19 |
Last Update Date | 2018-08-31 |