| NPI | 1619137981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY T ELLIS Insurance Clerk 706-546-7908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2009-03-31 |