| NPI | 1487098174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSIAH S MATTHEWS Owner 229-496-1874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207LP2900X Anesthesiology, Pain Medicine | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2018-11-07 |