| NPI | 1518505890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETE MARSHALL ATKINSON Administrator 870-862-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2019-12-17 |