| NPI | 1629081062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE ANN ODOM President Shared Services 947-522-3326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 363LN0000X Nurse Practitioner, Neonatal | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2021-10-21 |