| NPI | 1598049264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH KELLOUGH Chief Executive Officer 662-621-2192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MS 16776) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2011-09-29 |