| NPI | 1326243916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES STEPHEN GILES President CEO 270-384-6451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2016-11-18 |