| NPI | 1326040908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY PAYNE Credentialing 904-421-2119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2016-01-21 |