NPI | 1578741484 |
---|---|
Entity Type | Organization |
Authorized Contact | HOWARD CLAY JACKSON President 812-265-2592 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01019775) |
Enumeration Date | 2008-02-01 |
Last Update Date | 2008-03-11 |