| NPI | 1467493916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARTLEY TEAGUE Executive Director 731-512-1277 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207P00000X Emergency Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| 207V00000X Obstetrics & Gynecology | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine | |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 208600000X Surgery | |
| 207RI0200X Internal Medicine, Infectious Disease | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2025-10-30 |