| NPI | 1538215751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS TRIEU President 228-374-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 15594) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 17719) |
| 208000000X Pediatrics (Licence: MS 17719) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |