| NPI | 1699114827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE HODGES Controller 229-259-4140 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 092-141) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 092-141) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: GA 092-141) | |
| 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: GA 092-141) | |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: GA 092-141) | |
| 207RI0200X Internal Medicine Infectious Disease (Licence: GA 092-141) | |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: GA 092-141) | |
| 207RR0500X Internal Medicine Rheumatology (Licence: GA 092-141) | |
| 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: GA 092-141) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: GA 092-141) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: GA 092-141) | |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2019-08-22 |