| NPI | 1477434264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY J BAUGHEY Director 267-981-6519 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2025-09-09 |
| Last Update Date | 2025-09-16 |