NPI | 1497330625 |
---|---|
Doing Business As | SOUTHWELL PRIMARY CARE |
Entity Type | Organization |
Authorized Contact | TROY BROOKS SVP/CFO 229-353-3397 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
Enumeration Date | 2021-03-09 |
Last Update Date | 2022-10-18 |