| NPI | 1265616130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET T BURCHAM Credentialing Specialist 318-629-5002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2020-11-24 |