| NPI | 1356105597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY L BARTON Manager 228-363-3914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care |
| Enumeration Date | 2024-02-08 |
| Last Update Date | 2025-05-28 |