| NPI | 1407121338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYE D JONES Office Manager 601-719-0092 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2012-03-10 |
| Last Update Date | 2012-10-18 |