| 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 |