| NPI | 1649396979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIDA BYRD Billing Manager 901-737-3071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: AR R3762) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: AR R3762) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: AR R3762) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2011-12-01 |