| NPI | 1346423191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY DONAL BIVENS Manager 912-267-7780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 042537) |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2008-02-11 |