| NPI | 1609884733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINGER COX Office Manager 662-534-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2019-09-13 |