| NPI | 1619088838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE VOGT Medical Practice Manager 601-859-8992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 213E00000X Podiatrist | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-09-11 |