| NPI | 1275788010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL FOREST JACKSON President 877-827-6085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AL 11900) |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2008-11-20 |