| NPI | 1396895413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE TALBOT Director 601-296-3405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MS 139170) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MS 15450) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2021-07-28 |