| NPI | 1326239856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J LARRY BLACK President 662-562-6026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS MD0000008543) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2007-12-17 |