| NPI | 1497718134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF ERWIN Administrator 501-224-1690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207R00000X Internal Medicine | |
| 207K00000X Allergy & Immunology | |
| 207N00000X Dermatology | |
| 207RH0003X Internal Medicine Hematology & Oncology | |
| 207V00000X Obstetrics & Gynecology | |
| 207VE0102X Obstetrics & Gynecology Reproductive Endocrinology | |
| 208000000X Pediatrics | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2018-04-19 |