| NPI | 1508984436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN NOWELL Physician Practice Manager 662-624-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |