| NPI | 1285790915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA BRIDWELL Insurance Supervisor 334-712-1929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2011-08-03 |