| NPI | 1306894704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF KINGERY Director 270-706-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| 207LP2900X Anesthesiology, Pain Medicine | |
| 363L00000X Nurse Practitioner | |
| 207T00000X Neurological Surgery | |
| 363LF0000X Nurse Practitioner, Family | |
| 363A00000X Physician Assistant | |
| 207Q00000X Family Medicine | |
| 207Y00000X Otolaryngology | |
| 208800000X Urology | |
| 208600000X Surgery | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2017-03-31 |