| NPI | 1588751424 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KRISTI I LEE Practice Manager 706-774-7992  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 621111)  | 
| Enumeration Date | 2006-10-10 | 
| Last Update Date | 2008-06-11 |