| NPI | 1376764167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID G CHASE Owner 662-728-2147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MS 07824) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-08-22 |