| NPI | 1588803571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP K BLEVINS Owner 601-364-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck |
| 2082S0105X Plastic Surgery, Surgery of the Hand | |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2009-02-13 |