| NPI | 1477508612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY FRANCES BEASLEY Insurance Biller 910-596-0093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 94-01340) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2020-08-22 |