| NPI | 1326089830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA DEFORD ANDERSON Physician 601-984-2538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 16045) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2020-08-22 |