| NPI | 1316195373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN J. MADDOX Provider Enrollment COO Rdinator 912-350-9335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology |
| 207Y00000X Otolaryngology | |
| 2086S0102X Surgery Surgical Critical Care | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) | |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2011-05-03 |