| NPI | 1407299894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE G MITCHUM Owner 334-684-3007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 12381) |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2013-04-16 |