| NPI | 1548513617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE FERGUSON Administrator 601-948-6540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2016-01-20 |