| NPI | 1598900672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN W FISK Owner 601-983-7703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2008-12-03 |