| NPI | 1649267618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L JACKSON Senior Director, Enrollment 877-892-9815 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RC0000X Internal Medicine Cardiovascular Disease | |
| 207RP1001X Internal Medicine Pulmonary Disease | |
| 207RS0012X Internal Medicine Sleep Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 207X00000X Orthopaedic Surgery | |
| 208600000X Surgery | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2022-01-25 |