| NPI | 1356312623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY REUBEN CAPPLEMAN AO 662-539-7444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2024-08-12 |