| NPI | 1609929470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OWEN B EVANS Manager 601-984-5214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |