| NPI | 1275293078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVION SMITH Director, Payer Contracting 424-326-8711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| 213E00000X Podiatrist | |
| 213EP0504X Podiatrist, Public Medicine | |
| Enumeration Date | 2021-12-21 |
| Last Update Date | 2022-11-14 |