NPI | 1609203173 |
---|---|
Entity Type | Organization |
Authorized Contact | PEGGY LORRAINE NOONAN Physician Business Services Dir. 228-575-1740 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207R00000X Internal Medicine |
208000000X Pediatrics | |
Enumeration Date | 2013-09-30 |
Last Update Date | 2024-01-09 |