| NPI | 1457051591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE MICHELLE ALEXANDER Payroll And Accounts Specialist 601-992-9790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-03-07 |
| Last Update Date | 2023-03-07 |