| NPI | 1336259100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMIE G RICHMOND Billing 228-872-3993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2014-06-10 |