| NPI | 1265660708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY HENSON Rcd 336-944-6420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine |
| 2085R0202X Radiology Diagnostic Radiology | |
| 208600000X Surgery | |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2024-06-06 |