| NPI | 1336653393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY D JACOBS Owner 251-300-2418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: AL 27305) |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2017-11-28 |