| NPI | 1528374741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY LESTER WYATT President 904-981-9959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL ME64092) |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2010-08-25 |