| NPI | 1316279375 |
|---|---|
| Doing Business As | FOUNTAIN LAKE FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | RICHARD R FINCH Provider 501-625-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2010-02-02 |
| Last Update Date | 2014-08-26 |