| NPI | 1629025432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEELYN CLARK CUNNINGHAM Office Manager 706-854-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2008-11-05 |