| NPI | 1407114432 |
|---|---|
| Doing Business As | EMMANUEL MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | DONNA KAY PITTMAN CEO 601-209-5133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R845316) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2019-07-09 |