| NPI | 1477009181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH LOGAN PENN Physician / President 912-871-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 67374) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |