| NPI | 1609082338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMA M PHILLIPS Director Physician Billing 731-512-1510 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RI0200X Internal Medicine Infectious Disease |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2008-05-16 |