| NPI | 1255371753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRANVILLE LEROY VAUGHAN Owner/CEO 501-362-0048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR c7548) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2008-07-30 |