| NPI | 1447778584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RASHEA SIMS Office Manager 601-441-4780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MS 1044142) |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2017-09-08 |