| NPI | 1245833359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WINSTON PRICE COO 229-220-5674 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2020-11-19 |