| NPI | 1619322195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIE ANNE SHERRILL Office Manager 501-217-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AR 2949) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2016-05-03 |