| NPI | 1558572438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISSY LEMA GAMBER Director Of Credentialing 228-864-9669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 08597) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |