| NPI | 1427252766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN BOUTWELL Administration 334-671-2895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 00024928) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: AL 00024928) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2007-07-16 |