| NPI | 1568764504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI FEWELL Office Manager 601-292-1228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism |
| Additional Taxonomies | 174400000X Specialist (Licence: MS 19640) |
| 174400000X Specialist (Licence: MS 21031) | |
| 174400000X Specialist (Licence: MS 20965) | |
| Enumeration Date | 2010-11-24 |
| Last Update Date | 2023-05-30 |