| NPI | 1396978615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY MICHAEL STAMPER President 318-348-4699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2020-01-23 |