| NPI | 1366504789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONYA D HIX Office Administrator 706-754-5191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 26375) |
| Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine (Licence: GA 26375) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN124242) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2024-03-07 |