NPI | 1649203043 |
---|---|
Entity Type | Organization |
Authorized Contact | KATHY TEAGUE VP, Corporate Secretary 629-253-5121 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207R00000X Internal Medicine |
207RP1001X Internal Medicine, Pulmonary Disease | |
207X00000X Orthopaedic Surgery | |
208000000X Pediatrics | |
208600000X Surgery | |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2006-07-09 |
Last Update Date | 2023-04-13 |