| NPI | 1376528554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL STAFFORD Certified Surgical First Assistant 901-831-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical |
| Enumeration Date | 2005-12-11 |
| Last Update Date | 2008-05-07 |