| NPI | 1306256060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET M GLYNN President 662-424-3290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 12314) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MS 12314) |
| Enumeration Date | 2014-05-04 |
| Last Update Date | 2014-05-04 |