| NPI | 1336315639 |
|---|---|
| Former Legal Business Name | PARKWAY PLASTIC SURGERY PA |
| Entity Type | Organization |
| Authorized Contact | DAVID W. MOBLEY President 904-396-1186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME0020849) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME77532) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2014-10-29 |