| NPI | 1518040633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME GORDON JOHNSON President 304-599-1448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2010-06-22 |