| NPI | 1245584747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY BIBB Physician 601-259-0083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MS 19334) |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2012-11-06 |