| NPI | 1518692342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY D WILLIAMS Owner 662-274-3212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2022-07-17 |
| Last Update Date | 2022-09-01 |