| NPI | 1396151734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCINDA BOSWELL DRANE Practice Manager 601-445-0740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RS0012X Internal Medicine Sleep Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care (Licence: MS 1032011) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2021-04-19 |