| NPI | 1326319740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN THOMAS LEWIS Medical Doctor 228-864-8049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| Additional Taxonomies | 207N00000X Dermatology (Licence: LA MD14710R) |
| Enumeration Date | 2012-01-17 |
| Last Update Date | 2012-01-17 |