| NPI | 1386118917 |
|---|---|
| Doing Business As | PHYSICIANS PARK GENERAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | KIM G WITTENBORN Manager 573-331-3080 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2019-01-16 |