| NPI | 1619203809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | R. ALEXANDER WYNN President 912-754-0382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2009-10-23 |
| Last Update Date | 2021-01-13 |