| NPI | 1316331101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY GILLEY Administrator 334-712-1170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 2084N0400X Psychiatry & Neurology Neurology | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2015-03-19 |