| NPI | 1508022237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES W STEPHENS Owner / Operator 601-587-0209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: MS 20322) |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2008-12-30 |