| NPI | 1285204958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIT JADEJA Operations Head 479-372-3222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2021-06-25 |
| Last Update Date | 2021-06-25 |