| NPI | 1477578235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRION JEWAYNE PREWITT Owner 731-285-7530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RA0000X Internal Medicine Adolescent Medicine | |
| 207RA0201X Internal Medicine Allergy & Immunology | |
| 207RC0000X Internal Medicine Cardiovascular Disease | |
| 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism | |
| 207RG0100X Internal Medicine Gastroenterology | |
| 207RG0300X Internal Medicine Geriatric Medicine | |
| 207RI0200X Internal Medicine Infectious Disease | |
| 207RP1001X Internal Medicine Pulmonary Disease | |
| 207RR0500X Internal Medicine Rheumatology | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2010-12-13 |