| NPI | 1649564592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONOVAN R STOCKDALE Physician 870-932-4462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AR e2819) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2011-06-07 |