| NPI | 1659923316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUTUMN BAILEY Managed Care Director 270-887-0100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine Medical Oncology |
| Additional Taxonomies | 207RH0003X Internal Medicine Hematology & Oncology |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2019-07-12 |