NPI | 1295325611 |
---|---|
Entity Type | Organization |
Authorized Contact | VERNON DEAN BOWMAN President 430-200-4350 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2021-01-20 |
Last Update Date | 2025-02-26 |