| NPI | 1396808879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORIE A CHANDLER Billing Manager 662-236-2923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MS 18903) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2011-01-04 |