| NPI | 1508561978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN GIBSON Admin Asst/ Credentialing 662-767-4200 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2023-08-11 |