| NPI | 1316131048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VONDA RUSSELL Business Office Director 870-460-3514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 208600000X Surgery | |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2007-09-06 |