| NPI | 1538166053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAM HALL Surgical Director 229-241-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 092-272) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2020-08-22 |