| NPI | 1619084613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN F. SANFORD President 662-324-1291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2015-01-15 |