| NPI | 1528291341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE OLUTADE Physician 601-991-3040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MS 16022) |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2009-08-27 |