| NPI | 1548284060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTIE R STAUSS Physician Services Manager 629-255-2620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 103T00000X Psychologist |
| 207N00000X Dermatology | |
| 207Q00000X Family Medicine | |
| 207RA0201X Internal Medicine, Allergy & Immunology | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 207RR0500X Internal Medicine, Rheumatology | |
| 207V00000X Obstetrics & Gynecology | |
| 207W00000X Ophthalmology | |
| 208000000X Pediatrics | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2017-10-12 |