| NPI | 1578572293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY EVELYN MCKINLEY Doctor 478-841-2707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 051256) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 051256) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2019-02-11 |