| NPI | 1326149956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WINSTON CRAIG CLARK Owner 662-349-5660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TN MD14839) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2009-02-18 |