| NPI | 1407207111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONARD TERRY PYNES Authorized Member 334-791-5423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-23 |