NPI | 1417112053 |
---|---|
Entity Type | Organization |
Authorized Contact | ANTHONY O RUSSELL Physician 910-343-0300 |
Organization Subpart ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
Additional Taxonomies | 207R00000X Internal Medicine |
Enumeration Date | 2008-07-23 |
Last Update Date | 2008-07-23 |