| NPI | 1679053979 |
|---|---|
| Doing Business As | SOUTH 28TH AVENUE FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | BRYAN N BATSON Executive Director 601-264-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2021-02-22 |