| NPI | 1346534831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J JACKSON Owner 912-355-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 038019) |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2023-03-07 |