| NPI | 1578627782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEZELLE L HEADLEY Office Manager 601-437-3323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 09133) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2008-10-15 |