NPI | 1275515967 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIC JENSEN President 706-226-3139 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
207QA0401X Family Medicine, Addiction Medicine | |
Enumeration Date | 2005-11-17 |
Last Update Date | 2024-08-19 |