| NPI | 1578558698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID W ALRED Administrator 731-287-4512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 208000000X Pediatrics |
| 207R00000X Internal Medicine | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2020-08-22 |