| NPI | 1376508788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA TOLAR Insurance & Collection Supervisor 334-793-1881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 2080P0206X Pediatrics, Pediatric Gastroenterology | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2021-07-22 |