| NPI | 1619973682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA LOUISE JARVIS President 270-685-1066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2021-03-24 |