| NPI | 1306221841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT KEITH NORMAN Owner/President 270-393-1912 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 207L00000X Anesthesiology | |
| 208VP0000X | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 363L00000X Nurse Practitioner | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2022-06-24 |