| NPI | 1407944630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CECILY DENISE JACKSON Practice Manager 334-265-3140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-08-22 |