| NPI | 1578676078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTIS DALE MITCHUM President/Physician 334-684-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 2656) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2007-09-20 |