| NPI | 1639128143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN WALKER LEE Administrator 706-769-6469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2019-09-04 |